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Contact Information

ROOSEVELT FAMILY MEDICAL CENTER, INC.
4517 N BROAD ST
PHILADELPHIA, PA19140-1215
 Phone: 215-324-1900
 Fax: 215-324-4239
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ROOSEVELT FAMILY MEDICAL CENTER INC · (Female)

NPI Number 1114035326
Status Active
Credentials
Entity Individual
Enumeration date 08/28/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • PA Other 0058484001 10 DIGIT HMO ID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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