Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Great Health Medical PA PC

Organization Primary Care Nurse Practitioner · NPI 1750212056

Great Health Medical PA PC provides Primary Care Nurse Practitioner services in Philadelphia, Pennsylvania. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 S Juniper St Fl 3
Philadelphia, PA 19107-1316
Phone: (718) 470-0288
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X

Record details

NPI number1750212056
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sonika Randev — Md · (212) 734-6621
NPI enumeratedMay 26, 2026
Last updated in NPPESMay 26, 2026
Certification dateMay 26, 2026
Mailing address407 Willoughby Ave, Brooklyn, NY 11205-4590

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