Provider Demographics
NPI:1619029238
Name:TEMPLE PHYSICIANS INC.
Entity Type:Organization
Organization Name:TEMPLE PHYSICIANS INC.
Other - Org Name:TPI HENRY AVENUE PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVERING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2152-926-9015
Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-926-9000
Mailing Address - Fax:215-226-8285
Practice Address - Street 1:8500 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2111
Practice Address - Country:US
Practice Address - Phone:215-483-8865
Practice Address - Fax:215-483-8027
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEMPLE PHYSICIANS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-16
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1961465OtherHIGHMARK BLUE SHIELD
PACD4829OtherRRM
PA1007278000094Medicaid
PACD4829Medicare PIN
PACD4829OtherRRM