OrganizationActive
Fairmount Pediatrics and Adolescent Medicine
NPI 1487987020 · Primary Care Clinic/Center · Phila, PA
Provider details
- NPI number
- 1487987020
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Alexis Lieberman, Member Manager(215) 774-1166
- License
- MD059659L (PA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2000 Hamilton St
#109
Phila, PA 19130-3814
Phone: (215) 774-1166
Fax: (215) 279-8383
Approximate (ZIP-level) locationGet directions
Mailing address
7042 Greene St
Phila, PA 19119-3439
Registry dates
- Enumerated
- 2009-09-15
- Last updated
- 2009-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.