Provider Demographics
NPI:1215282165
Name:TEMPLE CARDIOLOGY AT JEANES
Entity type:Organization
Organization Name:TEMPLE CARDIOLOGY AT JEANES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:GARO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-722-4600
Mailing Address - Street 1:7600 CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2442
Mailing Address - Country:US
Mailing Address - Phone:215-722-4600
Mailing Address - Fax:215-722-1370
Practice Address - Street 1:7600 CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-722-4600
Practice Address - Fax:215-722-1370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty