Provider Demographics
NPI:1366292005
Name:BIRCHES HEALTH MEDICAL GROUP P A
Entity type:Organization
Organization Name:BIRCHES HEALTH MEDICAL GROUP P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPAPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-843-8445
Mailing Address - Street 1:100 S ASHLEY DR STE 600
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5300
Mailing Address - Country:US
Mailing Address - Phone:833-483-3838
Mailing Address - Fax:
Practice Address - Street 1:100 S ASHLEY DR STE 600
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5300
Practice Address - Country:US
Practice Address - Phone:833-483-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty