Active NPI 1124226907 Individual Practitioner Female Practitioner

Dr. Jodi Washinsky Lenko , MD

Internal Medicine • Hazleton, PA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Jodi Lenko, MD is a certified Internal Medicine practicing in Hazleton, PA. With approximately 19 years of clinical experience since graduating from Temple University School Of Medicine in 2007, Dr. Lenko delivers high-quality medical care to the local community at 1000 ALLIANCE DR.

Dr. Lenko is affiliated with Lehigh Valley Physician Group and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include injection, denosumab, 1 mg, established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1000 Alliance Dr

Hazleton, PA 182023234

Telephone 5704592226

Fax 5704592511

Associated Practice Facility / Clinic

🏢 Greater Hazleton Radiology Associates Facility NPI 1851348478

Medicare Profile & Education

Medical School

Temple University School Of Medicine

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Hazleton, PA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

19 Yrs -13.0 yrs vs City Avg

City Avg: 32.0 Yrs

State Avg: 28.2 Yrs

Regional Practice Density

15 Specialists

Practicing in Hazleton, PA (7609 Statewide)

Telehealth Adoption Rate

33.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

53.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lenko (19 Years) 19 Yrs

Hazleton Specialty Average (32.0 Years) 32.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,400	24	$60.00	$25.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	530	345	$250.00	$121.24
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	323	323	$247.94	$122.09
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	278	205	$35.00	$15.78
G0008 Administration of influenza virus vaccine	135	133	$60.00	$30.77
90662 Influenza vaccine split virus, preservative free	126	125	$150.00	$80.39
99213 Established patient office or other outpatient visit, typically 15 minutes	116	107	$180.00	$85.23
83036 Hemoglobin A1C level	107	86	$50.00	$9.44
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	84	48	$65.00	$13.21
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	80	20	$7.00	$0.87
90480 Admn sarscov2 vacc 1 dose	56	53	$80.00	$41.03
91320 Sarscv2 vac 30mcg trs-suc im	56	53	$260.00	$150.18
81003 Automated urinalysis test	37	31	$11.49	$2.20
99495 Transitional care management services for problem of at least moderate complexity	29	27	$400.00	$190.33
93000 Routine ekg using at least 12 leads including interpretation and report	23	23	$101.96	$13.54
G0444 Annual depression screening, 5 to 15 minutes	20	20	$35.00	$16.90
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$320.00	$157.93
G0009 Administration of pneumococcal vaccine	16	16	$60.00	$30.77
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	14	14	$580.00	$268.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	3,600	34	$48.50	$23.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	571	354	$212.19	$123.80
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	372	372	$215.00	$124.78
83036 Hemoglobin A1C level	156	118	$50.00	$9.46
G0008 Administration of influenza virus vaccine	131	129	$55.99	$29.45
90662 Influenza vaccine split virus, preservative free	117	117	$150.00	$71.93
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	110	55	$65.00	$13.67
99213 Established patient office or other outpatient visit, typically 15 minutes	91	82	$145.27	$86.06
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	62	17	$7.00	$1.07
90480 Admn sarscov2 vacc 1 dose	54	54	$80.00	$39.27
91320 Sarscv2 vac 30mcg trs-suc im	54	54	$260.00	$128.48
85610 Blood test, clotting time	49	15	$15.00	$4.20
G0009 Administration of pneumococcal vaccine	42	42	$46.07	$29.45
81003 Automated urinalysis test	37	32	$10.00	$2.14
99442 Telephone medical discussion with physician, 11-20 minutes	27	22	$180.00	$87.65
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	26	26	$535.77	$281.03
93000 Routine ekg using at least 12 leads including interpretation and report	20	20	$77.50	$13.97
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	17	17	$270.00	$123.11
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$295.00	$161.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	3,360	31	$40.00	$21.62
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	621	363	$205.00	$125.26
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	350	350	$215.00	$128.00
83036 Hemoglobin A1C level	161	116	$45.25	$9.77
G0008 Administration of influenza virus vaccine	155	153	$54.71	$28.32
99213 Established patient office or other outpatient visit, typically 15 minutes	155	134	$140.00	$88.31
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	149	148	$125.00	$69.93
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	110	23	$7.00	$1.33
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	103	56	$65.00	$13.86
G0009 Administration of pneumococcal vaccine	87	85	$45.00	$28.43
85610 Blood test, clotting time	56	13	$15.00	$4.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$315.00	$159.58
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	53	53	$530.00	$278.26
81003 Automated urinalysis test	42	36	$10.00	$2.40
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	33	33	$65.00	$21.87
93000 Routine ekg using at least 12 leads including interpretation and report	31	31	$75.00	$14.00
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	27	27	$242.22	$132.14
99442 Telephone medical discussion with physician, 11-20 minutes	26	26	$180.00	$82.51
90471 Administration of 1 vaccine	26	26	$45.00	$15.02
99495 Transitional care management services for problem of at least moderate complexity	22	21	$315.00	$178.22
90472 Administration of vaccine, each additional vaccine	17	14	$25.00	$12.30
69210 Removal of impacted ear wax	14	14	$100.00	$46.70
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$205.00	$110.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,040	22	$40.00	$20.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	427	265	$205.00	$126.50
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	305	305	$215.00	$128.07
99213 Established patient office or other outpatient visit, typically 15 minutes	305	233	$140.00	$89.09
G0008 Administration of influenza virus vaccine	174	174	$50.00	$16.40
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	161	161	$125.00	$65.60
83036 Hemoglobin A1C level	158	107	$35.00	$9.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$205.00	$109.15
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	84	20	$7.00	$1.27
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	75	40	$65.00	$13.78
G0009 Administration of pneumococcal vaccine	72	72	$45.00	$16.43
85610 Blood test, clotting time	62	14	$15.00	$4.29
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	61	61	$65.00	$21.99
81003 Automated urinalysis test	57	41	$10.00	$2.25
93000 Routine ekg using at least 12 leads including interpretation and report	47	45	$72.66	$14.42
99442 Telephone medical discussion with physician, 11-20 minutes	41	37	$180.00	$89.73
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	38	38	$220.00	$125.45
99495 Transitional care management services for problem of at least moderate complexity	37	35	$315.00	$200.89
90670 Pneumococcal vaccine for injection into muscle	34	34	$415.00	$239.40
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	18	18	$30.00	$19.28
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$295.00	$164.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$315.00	$164.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,620	17	$40.00	$19.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	561	316	$205.00	$106.77
99213 Established patient office or other outpatient visit, typically 15 minutes	211	156	$140.00	$73.11
83036 Hemoglobin A1C level	132	87	$35.00	$9.57
G0008 Administration of influenza virus vaccine	132	130	$39.55	$16.26
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	126	126	$215.00	$114.14
G0009 Administration of pneumococcal vaccine	110	110	$45.00	$16.18
99442 Telephone medical discussion with physician, 11-20 minutes	93	77	$167.90	$72.32
90653 Vaccine for influenza for injection into muscle	83	83	$115.00	$57.38
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	61	32	$65.00	$14.02
90670 Pneumococcal vaccine for injection into muscle	60	60	$415.00	$222.06
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	59	15	$5.00	$1.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	55	55	$205.00	$106.19
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	50	50	$220.00	$118.96
85610 Blood test, clotting time	37	15	$15.00	$4.25
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	37	37	$123.92	$61.00
81002 Urinalysis, manual test	35	28	$10.00	$3.45
93000 Routine ekg using at least 12 leads including interpretation and report	30	30	$65.00	$16.18
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	22	22	$65.00	$22.71
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	21	18	$105.00	$52.55
G0296 Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)	14	12	$60.00	$29.48
99495 Transitional care management services for problem of at least moderate complexity	13	13	$315.00	$182.85
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	13	13	$30.00	$14.21
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$295.00	$163.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,200	14	$40.00	$18.67
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	736	355	$205.29	$106.11
99213 Established patient office or other outpatient visit, typically 15 minutes	280	202	$140.17	$71.17
G0008 Administration of influenza virus vaccine	149	145	$35.00	$15.95
83036 Hemoglobin A1C level	143	90	$35.35	$10.42
90662 Influenza vaccine split virus, preservative free	134	131	$79.01	$54.36
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	108	25	$5.19	$1.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	94	42	$65.00	$16.25
85610 Blood test, clotting time	65	14	$15.00	$4.28
G0009 Administration of pneumococcal vaccine	62	61	$45.03	$15.95
81002 Urinalysis, manual test	41	30	$10.00	$3.41
90670 Pneumococcal vaccine for injection into muscle	40	40	$415.00	$204.49
93000 Routine ekg using at least 12 leads including interpretation and report	40	36	$65.75	$16.21
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$205.26	$106.51
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	36	16	$108.89	$72.58
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	23	23	$220.00	$111.65
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	22	18	$104.18	$52.23
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	17	17	$215.00	$114.19
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	16	15	$29.06	$18.65
81003 Automated urinalysis test	16	15	$10.00	$2.44
36415 Insertion of needle into vein for collection of blood sample	16	15	$15.00	$2.94
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	13	13	$40.00	$16.64
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$295.00	$163.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	782	381	$209.00	$103.92
99213 Established patient office or other outpatient visit, typically 15 minutes	387	255	$142.00	$69.22
36415 Insertion of needle into vein for collection of blood sample	372	254	$15.00	$2.94
83036 Hemoglobin A1C level	201	127	$45.00	$11.75
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	134	48	$105.00	$71.87
G0008 Administration of influenza virus vaccine	99	98	$34.60	$19.57
90662 Influenza vaccine split virus, preservative free	83	83	$60.33	$52.30
85610 Blood test, clotting time	83	28	$30.00	$4.75
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	70	19	$10.00	$1.82
G0009 Administration of pneumococcal vaccine	56	56	$46.00	$19.57
81002 Urinalysis, manual test	44	40	$53.00	$3.41
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	42	31	$52.45	$19.69
90670 Pneumococcal vaccine for injection into muscle	33	33	$370.67	$199.16
93000 Routine ekg using at least 12 leads including interpretation and report	32	32	$75.00	$16.42
99239 Hospital discharge day management, more than 30 minutes	31	26	$145.00	$105.99
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	31	29	$400.00	$200.07
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	24	24	$164.58	$105.59
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	23	21	$99.00	$52.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$210.00	$105.70
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	16	16	$28.44	$18.65
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$175.00	$134.96
99217 Hospital observation care on day of discharge	14	13	$100.00	$71.84
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	11	11	$160.00	$113.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	965	426	$142.00	$70.18
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	957	415	$209.12	$102.61
36415 Insertion of needle into vein for collection of blood sample	583	344	$15.00	$2.94
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	427	134	$105.00	$70.76
83036 Hemoglobin A1C level	269	145	$45.00	$13.01
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	228	54	$10.00	$1.81
85610 Blood test, clotting time	219	38	$30.00	$5.24
G0008 Administration of influenza virus vaccine	138	137	$30.00	$24.05
99239 Hospital discharge day management, more than 30 minutes	113	88	$145.00	$104.98
81002 Urinalysis, manual test	89	68	$53.00	$3.43
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	87	68	$397.41	$197.61
90662 Influenza vaccine split virus, preservative free	83	82	$78.10	$48.05
G0009 Administration of pneumococcal vaccine	82	81	$46.00	$24.05
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	74	51	$48.00	$24.18
93000 Routine ekg using at least 12 leads including interpretation and report	63	60	$75.00	$16.29
90670 Pneumococcal vaccine for injection into muscle	56	56	$335.14	$183.93
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	53	53	$36.00	$18.65
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	49	45	$175.00	$134.28
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	43	24	$150.00	$102.31
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	33	32	$99.00	$51.91
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	31	16	$7.00	$2.90
69209 Removal of impacted ear wax by washing	28	24	$24.86	$12.14
99217 Hospital observation care on day of discharge	27	26	$100.00	$71.14
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	25	25	$150.00	$95.47
99219 Hospital observation care, typically 50 minutes	24	24	$145.00	$133.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$210.00	$101.00
99238 Hospital discharge day management, 30 minutes or less	22	22	$138.00	$70.80
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$135.00	$99.62
99220 Hospital observation care, typically 70 minutes	12	12	$230.00	$182.06

Medical Specialties & State Licenses

CMS Verified: 2020-02-13

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License PA MD437983

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License PA MT190695

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

102487848-0004 (PA)

Hospital & Practice Group Affiliations

Lehigh Valley Physician Group

2649 Schoenersville Rd, Bethlehem, PA 180177326

Phone: 4848848110

Secondary Practice Locations

1730 E Broad Street, Suite 1

Hazleton, PA 18201

Phone: 5704592226

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Amanda Evans , PA-C

Physician Assistant - Medical

NPI 1528480639

Physician Assistant (Certified)

Shanna Kulick , CRNP

Nurse Practitioner - Family

NPI 1578233102

Certified Registered Nurse Practitioner

Dr. Nicole Balchune , DO

Internal Medicine

NPI 1659505931

Doctor of Osteopathic Medicine (D.O.)

Michele Holincheck , CRNP

Nurse Practitioner - Family

NPI 1689907248

Certified Registered Nurse Practitioner

Dr. Michael Washinsky , DO

Family Medicine

NPI 1801821194

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location February 13, 2020

Registered at 1000 ALLIANCE DR, HAZLETON, PA 182023234 (Tel: 5704592226)

📍

Updated Business Mailing Address February 13, 2020

Registered at PO BOX 783311, PHILADELPHIA, PA 191783311 (Tel: 4848844500)

✅

NPI Profile Active April 01, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location April 01, 2014

Registered at 1730 E BROAD STREET, SUITE 1, HAZLETON, PA 18201 (Tel: 5704592226)

📍

Updated Business Mailing Address April 01, 2014

Registered at PO BOX 1347, KINGSTON, PA 187040347 (Tel: 5702888881)

👤

Provider Name / Credentials Updated April 01, 2014

Recorded as JODI LENKO, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2014

Internal Medicine (License #MT190695 in PA)

🟢

Initial NPI Registration & Enumeration July 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1124226907

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 03, 2007

Last Update: February 13, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 783311

Philadelphia, PA 191783311

Phone: 4848844500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.