| NPI | 1144274077 |
|---|---|
| Doing Business As | GPHA 4TH STREET MEDICAL SUITE |
| Entity Type | Organization |
| Authorized Contact | D TINA SMITH Provider Enrollment Spec. 215-925-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 213E00000X Podiatrist | |
| 176B00000X Midwife | |
| 101Y00000X Counselor | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2080C0008X Pediatrics, Child Abuse Pediatrics | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2017-03-15 |