Provider Demographics
NPI:1720138928
Name:HEALTH AND BEAUTY MEDICAL, PC
Entity Type:Organization
Organization Name:HEALTH AND BEAUTY MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OSTEOPATIC MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANDROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DO
Authorized Official - Phone:215-676-0919
Mailing Address - Street 1:9708 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-3106
Mailing Address - Country:US
Mailing Address - Phone:215-676-0919
Mailing Address - Fax:215-676-0939
Practice Address - Street 1:9708 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-3106
Practice Address - Country:US
Practice Address - Phone:215-676-0919
Practice Address - Fax:215-676-0939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012725207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA085528Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER