NPI: 1487987020 · PHILA, PA 19130 · Primary Care Clinic/Center · NPI assigned 09/15/2009
| Authorized Official | LIEBERMAN, ALEXIS (MEMBER MANAGER) |
| NPI Enumeration Date | 09/15/2009 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 17 | $315.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 17 | 14 | $315.00 |