Basic Information
Provider Information
NPI: 1417135161
EntityType: 2
ReplacementNPI:  
OrganizationName: PHILADELPHIA HEALTH & EDUCATION CORPORATION
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: DREXEL VAGINITIS CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 CHERRY ST
Address2: SUITE 11511
City: PHILADELPHIA
State: PA
PostalCode: 191021321
CountryCode: US
TelephoneNumber: 2152557822
FaxNumber: 2152557825
Practice Location
Address1: 216 N BROAD ST
Address2: 4TH FLOOR, FEINSTEIN
City: PHILADELPHIA
State: PA
PostalCode: 191021121
CountryCode: US
TelephoneNumber: 2157623600
FaxNumber: 2157624323
Other Information
ProviderEnumerationDate: 02/05/2008
LastUpdateDate: 04/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MEINDL
AuthorizedOfficialFirstName: LOU
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EXEC. DIRECTOR OF FINANCE
AuthorizedOfficialTelephone: 2157621321
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VG0400X PAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology

No ID Information.


Home