Provider Demographics
NPI:1710691860
Name:DIRECT CARE ENDOCRINOLOGY LLC
Entity Type:Organization
Organization Name:DIRECT CARE ENDOCRINOLOGY LLC
Other - Org Name:DIRECT CARE ENDOCRINOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIOLETA
Authorized Official - Middle Name:
Authorized Official - Last Name:POPII
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-287-3788
Mailing Address - Street 1:931 CEDAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1629
Mailing Address - Country:US
Mailing Address - Phone:215-287-3788
Mailing Address - Fax:
Practice Address - Street 1:551 W LANCASTER AVE STE 205
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1419
Practice Address - Country:US
Practice Address - Phone:215-287-3788
Practice Address - Fax:484-275-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty