Provider Demographics
NPI:1811989304
Name:BERKS GENESIS FAMILY MEDICINE PC
Entity type:Organization
Organization Name:BERKS GENESIS FAMILY MEDICINE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:G
Authorized Official - Last Name:FLORES-POSADAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-378-0107
Mailing Address - Street 1:1555 SCHUYLKILL AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-1312
Mailing Address - Country:US
Mailing Address - Phone:610-378-0107
Mailing Address - Fax:610-378-7984
Practice Address - Street 1:1555 SCHUYLKILL AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-1312
Practice Address - Country:US
Practice Address - Phone:610-378-0107
Practice Address - Fax:610-378-7984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA167736Medicaid
PA167736Medicaid