Basic Information
| Provider Information | |||||||||
| NPI: | 1346263480 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HO | ||||||||
| FirstName: | REGINALD | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 925 CHESTNUT STREET | ||||||||
| Address2: | MEZZANINE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159555050 | ||||||||
| FaxNumber: | 2159557499 | ||||||||
| Practice Location | |||||||||
| Address1: | 925 CHESTNUT ST | ||||||||
| Address2: | MEZZANINE FLOOR | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159555050 | ||||||||
| FaxNumber: | 2159557499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 04/09/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD-057592-L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | MD-057592-L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | MD-057592-L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 001800789 | 05 | PA | MEDICAID | 8218005 | 05 | NJ | MEDICAID |