Provider Demographics
NPI:1104152198
Name:2000 SG ASSOCIATES PC
Entity type:Organization
Organization Name:2000 SG ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINCOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-224-8980
Mailing Address - Street 1:2000 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3994
Mailing Address - Country:US
Mailing Address - Phone:215-564-3618
Mailing Address - Fax:215-564-2239
Practice Address - Street 1:2000 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3994
Practice Address - Country:US
Practice Address - Phone:215-564-3618
Practice Address - Fax:215-564-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty