Organization · Type 2 NPI

Vine Street Medical and Associates

Addiction Medicine (Family Medicine) Physician · Philadelphia, PA

NPI number 1861921389 Active

Practice location

6323 Vine St
Philadelphia, PA 19139-1032

Fax (267) 292-5648

Specialties and licenses

TaxonomyCodeLicense
Addiction Medicine (Family Medicine) Physician Primary 207QA0401XMD032595E (PA)

Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.

2 other providers at this address

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About NPI 1861921389

Vine Street Medical and Associates's National Provider Identifier is 1861921389, issued on Jun 8, 2017. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 11, 2025.