Basic Information
| Provider Information | |||||||||
| NPI: | 1477605095 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TEMPLE PHYSICIANS INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | TPI NEH SURGERY | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 820933 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159269000 | ||||||||
| FaxNumber: | 2152268285 | ||||||||
| Practice Location | |||||||||
| Address1: | 2230 E ALLEGHENY AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191343830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156343418 | ||||||||
| FaxNumber: | 2156344872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 02/01/2008 | ||||||||
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| AuthorizedOfficialLastName: | SAVERING | ||||||||
| AuthorizedOfficialFirstName: | LYNNIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2159269015 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | TEMPLE PHYSICIANS INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 30027785 | 01 | PA | KEYSTONE MERCY | OTHER | 15730 | 01 | PA | ELDER HEALTH | OTHER | 7832788 | 01 | PA | AETNA PPO | OTHER | 35999 | 01 | PA | HEALTH PARTNERS SITE # | OTHER | 0756985000 | 01 | PA | IBC (KHPE & PC) | OTHER | 8080392 | 01 | PA | CIGNA CAP & PPO | OTHER | 1170578 | 01 | PA | AETNA HMO | OTHER | 1961998 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | CD4829 | 01 | PA | RAILROAD MEDICARE | OTHER |