Provider Demographics
NPI:1912964438
Name:DURHAM PHYSICIANS PC
Entity Type:Organization
Organization Name:DURHAM PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ENRICO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIRIENZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-752-5433
Mailing Address - Street 1:833 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:PENNDEL
Mailing Address - State:PA
Mailing Address - Zip Code:19047-5736
Mailing Address - Country:US
Mailing Address - Phone:215-752-5433
Mailing Address - Fax:215-752-1904
Practice Address - Street 1:833 DURHAM RD
Practice Address - Street 2:
Practice Address - City:PENNDEL
Practice Address - State:PA
Practice Address - Zip Code:19047-5736
Practice Address - Country:US
Practice Address - Phone:215-752-5433
Practice Address - Fax:215-752-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA010629Medicare ID - Type Unspecified