Provider Demographics
NPI:1477698181
Name:VINOKUR, EMMA (BE)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:
Last Name:VINOKUR
Suffix:
Gender:F
Credentials:BE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 N ASH CIRCLE
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929
Mailing Address - Country:US
Mailing Address - Phone:215-343-7785
Mailing Address - Fax:
Practice Address - Street 1:10125 VERREE RD SUITE 304
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116
Practice Address - Country:US
Practice Address - Phone:215-673-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000008810025Medicaid