Provider Demographics
NPI:1376689380
Name:TWERSKY, MELVIN Z (DO)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:Z
Last Name:TWERSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2306
Mailing Address - Country:US
Mailing Address - Phone:215-927-7806
Mailing Address - Fax:215-927-5212
Practice Address - Street 1:7515 STENTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-3710
Practice Address - Country:US
Practice Address - Phone:267-335-5264
Practice Address - Fax:215-752-5542
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01824OtherHEALTH PARTNERS SR GROUP#
PAD98604OtherHEALTH PARTNERS SR INDIV#
PA0066647OtherBLUE SHIELD
PA0057980000OtherPERSONALCHOICE PA GROUP#
PA01824OtherHEALTH PARTNERS GROUP #
PA100002OtherKEYSTONEMERCY INDIV #
PA100181OtherKEYSTONEMERCY HEALTHGR#
PAOS003955-LOtherOSTEOPATHIC LICENSE
PA0057980001OtherKEYSTONE EAST GROUP #
PA0068394602OtherAMERICHOICE GROUP #
PA1302OtherELDER HEALTH
PA00683946Medicaid
PAD98604OtherHEALTH PARTNERS INDIV #
PA0066647OtherBLUE SHIELD
PA00683946Medicaid
PA066647Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #