Provider Demographics
NPI:1104881697
Name:ADIRIM, TERRY ALAYNE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALAYNE
Last Name:ADIRIM
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:3601 A ST
Mailing Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 A ST
Practice Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1043
Practice Address - Country:US
Practice Address - Phone:215-427-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD 052098L2080P0204X, 2080S0010X
DC20729 MD2080P0204X, 2080S0010X
MDD00505682080P0204X, 2080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC003727M30Medicare PIN