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Contact Information

PEACH STATE MEDICAL PRACTICE, PC
1414 WALNUT ST
PHILADELPHIA, PA19102-3824
 Phone: 855-563-2639
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Reproductive Endocrinology

207VE0102X 16 Physician/Obstetrics & Gynecology
 

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for PEACH STATE MEDICAL PRACTICE, PC

NPI # 1174270805
LBN Legal business name PEACH STATE MEDICAL PRACTICE, PC
Authorized official FAHIMEH SASAN - (FOUNDING OBGYN)
Entity Organization
Organization subpart 1 No
Enumeration date 03/02/2022
Last updated 05/20/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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