Provider Demographics
NPI:1801178728
Name:ACCUCARE MEDICAL SERVICE
Entity Type:Organization
Organization Name:ACCUCARE MEDICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DONGFANG DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:YIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-473-8889
Mailing Address - Street 1:1445 CITY AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3831
Mailing Address - Country:US
Mailing Address - Phone:215-473-8889
Mailing Address - Fax:610-910-3889
Practice Address - Street 1:1445 CITY AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3831
Practice Address - Country:US
Practice Address - Phone:215-473-8889
Practice Address - Fax:610-910-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066380L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty