Provider Demographics
NPI:1689779639
Name:PIZZICA HEALTH SYSTEM
Entity Type:Organization
Organization Name:PIZZICA HEALTH SYSTEM
Other - Org Name:MEMPHIS STREET PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-707-1059
Mailing Address - Street 1:3380 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4510
Mailing Address - Country:US
Mailing Address - Phone:215-426-5566
Mailing Address - Fax:215-739-3904
Practice Address - Street 1:1364 E HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-4931
Practice Address - Country:US
Practice Address - Phone:215-289-3390
Practice Address - Fax:215-289-7072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty