Basic Information
| Provider Information | |||||||||
| NPI: | 1437668225 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EINSTEIN COMMUNITY HEALTH ASSOCIATES, INC. | ||||||||
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| OtherOrganizationName: | ECHA INTERNAL MEDICINE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5501 OLD YORK ROAD | ||||||||
| Address2: | KORMAN, SUITE 202 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191413018 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 E OLNEY AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191202470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159271937 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2017 | ||||||||
| LastUpdateDate: | 02/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | CANDIA | ||||||||
| AuthorizedOfficialFirstName: | DAWN | ||||||||
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| AuthorizedOfficialTitleorPosition: | SUPERVISOR, ENROLLMENT | ||||||||
| AuthorizedOfficialTelephone: | 2154654694 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0015771700023 | 05 | PA | MEDICAID |