Organization · NPI-2

2126 Fairmount Medical, INC.

Internal Medicine · Philadelphia, PA

NPI number1114972114
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1114972114
Entity type
Organization (NPI-2)
Legal business name
2126 Fairmount Medical, INC.
Organization subpart
No
Enumeration date
May 24, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

2126 Fairmount Ave
Philadelphia, PA 19130-2603

Phone 215-236-4600 · Fax 215-236-4609

Mailing address

2126 Fairmount Ave
Philadelphia, PA 19130-2603

Phone 215-236-4600 · Fax 215-236-4609

Authorized official

Frank Joseph Mondschein
Physician Co-Owner
2152364600

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