Randolph, Frederick

Randolph, Frederick is an individual health care provider with primary practice located at 1020 Sansom St Suite 239, Philadelphia PA 19107-5002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Randolph, Frederick can be contacted via phone (215) 955-6844.

Contact Information

Primary practice address
1020 Sansom St Suite 239 Philadelphia PA 19107-5002
Phone: (215) 955-6844
Fax: (215) 955-2526
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD419725 Pennsylvania

Profile Details

NPI number 1154388445
LBN Legal business name Randolph, Frederick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Dec 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154388445 NPPES
New Jersey MEDICAID 0100072
New Jersey MEDICAID 1010267480005
New Jersey MEDICAID 101026748

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