Provider Demographics
NPI:1407638794
Name:TEMPLE FACULTY PRACTICE PLAN INC
Entity Type:Organization
Organization Name:TEMPLE FACULTY PRACTICE PLAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. MANAGER PAYER CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-2433
Mailing Address - Street 1:3500 N BROAD ST
Mailing Address - Street 2:RM 001A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:502 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9544
Practice Address - Country:US
Practice Address - Phone:215-707-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty