Provider Demographics
NPI:1104682509
Name:PAMA MEDICAL CENTER PLLC
Entity type:Organization
Organization Name:PAMA MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY HEALTH CARE PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP, AGACNP-BC
Authorized Official - Phone:267-449-9387
Mailing Address - Street 1:706 REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3326
Mailing Address - Country:US
Mailing Address - Phone:267-449-9387
Mailing Address - Fax:
Practice Address - Street 1:7236 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1533
Practice Address - Country:US
Practice Address - Phone:267-449-9387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care