Dieckman, Elizabeth

Dieckman, Elizabeth is an individual health care provider with primary practice located at 260 S Broad St , Philadelphia PA 19102-5021. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dieckman, Elizabeth can be contacted via phone (215) 985-2500.

Contact Information

Primary practice address
260 S Broad St Philadelphia PA 19102-5021
Phone: (215) 985-2500
Fax: (267) 765-2325
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X SP008971 Pennsylvania

Profile Details

NPI number 1699947366
LBN Legal business name Dieckman, Elizabeth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2008
Last updated Nov 21st, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699947366 NPPES
Pennsylvania MEDICAID 1022188860001

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