Provider Demographics
NPI:1205953858
Name:RALPH, PAMELA J (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:RALPH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3801 MARKET ST
Mailing Address - Street 2:SUITE #201
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3153
Mailing Address - Country:US
Mailing Address - Phone:215-596-8100
Mailing Address - Fax:215-382-4405
Practice Address - Street 1:26 S 40TH ST
Practice Address - Street 2:3RD FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3009
Practice Address - Country:US
Practice Address - Phone:215-495-1792
Practice Address - Fax:215-382-4405
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD048435L2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001498595Medicaid
PAG09877Medicare UPIN
PA787159Medicare ID - Type Unspecified