Phyllis H. Goltra, P.C.

LBN: Phyllis H. Goltra, P.C.
Phyllis H. Goltra, P.C. is an health care organization with primary practice located at 1616 Walnut St Suite 1616, Philadelphia PA 19103-5313. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Phyllis H. Goltra, P.C. can be contacted via phone (215) 545-8441, or through Goltra, Phyllis H. via phone (215) 545-8441.

Contact Information

Primary practice address
1616 Walnut St Suite 1616 Philadelphia PA 19103-5313
Fax: (215) 985-1129
Website:
Authorized official contact:
Name: Goltra, Phyllis H. PH.D.

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS006504L Pennsylvania

Profile Details

NPI number 1164487500
LBN Legal business name Phyllis H. Goltra, P.C.
DBA Doing business as
Authorized official Goltra, Phyllis H. PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 19th, 2006
Last updated Jun 1st, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164487500 NPPES
Pennsylvania MEDICAID 7244008

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