| NPI | 1104882646 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-04-25 |
| Last Updated | 2008-03-11 |
| Mailing Address | 1 W Elm St, Suite 100 Conshohocken, PA 19428-2007 United States Phone: (610) 567-6967 | Fax: (610) 567-6170 📍 View Map |
| Primary Practice Address | 2701 Holme Ave, Suite 201 Philadelphia, PA 19152-2029 United States Phone: (215) 350-7417 | Fax: (215) 335-6303 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | PA | 0019378550002 | — |
| Other (non-Medicare) | PA | 1194654 | Aetna USH HMO |
| Other (non-Medicare) | PA | 1442044 | PA Blue Shield # |
| Other (non-Medicare) | PA | 203261266 | Coventry |
| Other (non-Medicare) | PA | 203261266 | UnitedHealthCare |
| Other (non-Medicare) | PA | 2125868000 | IBC # |
| Other (non-Medicare) | PA | 30029002 | KMHP |
| Other (non-Medicare) | PA | 30043419 | KMHP Woodward |
| Other (non-Medicare) | PA | 37809MD418392 | HealthPartners |
| Other (non-Medicare) | PA | 7546410 | Aetna USH PPO |
| Other (non-Medicare) | PA | 9254256 | Cigna |
| Other (non-Medicare) | PA | 9973 | Bravo ElderHealth |
| Other (non-Medicare) | — | Highmark Blue Shield | 1442044 |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207R00000X – Internal Medicine | PA | MD418392 |
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About NPI 1104882646
Violetta Berdichevskaya M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1104882646. The primary specialty listed is Internal Medicine. The provider is located in Philadelphia, PA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-04-25. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104882646?
NPI 1104882646 belongs to Violetta Berdichevskaya M.D., a Internal Medicine in Philadelphia, PA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104882646 active?
The current status of NPI 1104882646 in the NPPES registry is Active. The record was last updated on 2008-03-11.
What specialty is NPI 1104882646?
NPI 1104882646 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104882646?
You can verify NPI 1104882646 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104882646?
The primary practice address on file for NPI 1104882646 is 2701 Holme Ave, Philadelphia, PA 19152-2029. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104882646 issued?
NPI 1104882646 was first issued (enumerated) on 2006-04-25. The NPPES record was last updated on 2008-03-11.
Practice Location Map
Violetta Berdichevskaya is located at 2701 Holme Ave, Philadelphia, PA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Violetta Berdichevskaya. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104882646. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine | MD418392 | PA |