Mrs. Pearl A Lake
Military Health Care Provider

Address: 2214 S 57th St, Philadelphia, PA 19143-5705
Phone: 8868848807

Mrs. Pearl A Lake (NPI# 1053907261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1053907261
Entity Type Individual
Full Name Mrs. Pearl A Lake
Gender Female
Practice Address 2214 S 57th St
Philadelphia
PA 19143-5705
Practice Telephone 8868848807
Practice Fax Number 2158255161
Mailing Address 2250 E Monmouth St
Philadelphia
PA 19134-4103
Mailing Telephone 2678848807
Mailing Fax Number 2158255161
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2020-12-12
Last Update Date 2020-12-12

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 171000000X Military Health Care Provider Other Service Providers 7000.000000634RM PA
No 171000000X Military Health Care Provider Other Service Providers 70000634RMA PA

Taxonomy Information

Taxonomy Code 171000000X
Grouping Other Service Providers
Classification Military Health Care Provider

Taxonomy Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Notes: [7/1/2005: new]

Providers in the same taxonomy and city

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1740307099 Uscg Sector Delaware Bay Military Health Care Provider 1 Washington Ave, Philadelphia, PA 19147-4335 2007-03-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306109582 Jessica Lee Mash Military Health Care Provider 3456 Beale Ave, Altoona, PA 16601-1312 2012-06-21
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1689664666 Elnora S De Leon Military Health Care Provider 5450 Carlisle Pike, Bldg 23 A, Mechanicsburg, PA 17050-2411 2005-10-21
1730722075 Nichele Oglesby Military Health Care Provider 1700 S Lincoln Ave, Lebanon, PA 17042-7529 2019-10-18
1447657770 Elizabeth Helen Ameigh Military Health Care Provider 401 Penn Ave, Scranton, PA 18503-1213 2014-12-02
1134559594 Eric Miller Military Health Care Provider 7180 Highland Dr, Pittsburgh, PA 15206-1206 2013-11-22
1023270139 Alvin Warren Military Health Care Provider 1010 Delafield Rd, Pittsburgh, PA 15240-1005 2008-06-30
1225217482 Claudia Marie Roberts Military Health Care Provider 155 Wilson Ave, Washington, PA 15301-3336 2007-10-24
1083814412 Margaret Mary Casteel Military Health Care Provider 7180 Highland Dr, Bldg 5, 122b-h, Pittsburgh, PA 15206-1206 2007-07-24
1346344736 Richard Victor Brown Military Health Care Provider Veterans Administration Medical Center, University Drive C, Pittsburgh, PA 15240 2006-09-07
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Office Location

Street Address 2214 S 57TH ST
City PHILADELPHIA
State PA
Zip Code 19143-5705

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1366924011 Whitney Tamika Carter Specialist/Technologist 5526 Ridgewood St, Philadelphia, PA 19143 2018-08-29
1639662190 Mattew Muchnick Physical Therapist 4730 Hazel Ave 2r, Philadelphia, PA 19143 2018-06-10
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1205352671 New Visions Case Management & Consulting, LLC Social Worker 726 S 55th Street, Philadelphia, PA 19143 2017-08-17
1104342583 Mercy Management of Southeastern Pennsylvania Orthopaedic Surgery 501 S 54th St Ste 28, Phila, PA 19143 2017-08-17
1093238388 Blessed Hands Home Care Agency L.l.c. Home Health 433 S. 57th Street, Phila, PA 19143 2017-07-19
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Competitor

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City PHILADELPHIA
Zip Code 19143

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.