Provider Demographics
NPI:1821072059
Name:FION, GLADYS LORENA (MD)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:LORENA
Last Name:FION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:2ND FL TPI
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-926-9019
Mailing Address - Fax:215-226-8286
Practice Address - Street 1:100 E LEHIGH AVE
Practice Address - Street 2:CHC 1
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19125-1000
Practice Address - Country:US
Practice Address - Phone:215-707-1866
Practice Address - Fax:215-707-1876
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD067977L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1370738OtherHIGHMARK BLUE SHIELD
PA30001625OtherKMHP
PA3Y2518OtherHEALTH NET
PA2062523000OtherINDEPENDENCE BLUE CROSS
PAP00025009OtherRR MEDICARE
PA3209015OtherAETNA HMO
PA483430OtherCOVENTRY HEALTH AMERICA
PA7338285OtherAETNA PPO
PA9317OtherBRAVO HEALTH
H33748Medicare UPIN
PAP00025009OtherRR MEDICARE