Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wyncote Physical Medicine & Diagnostic PC

Organization Physical Medicine & Rehabilitation Physician · NPI 1043311764

Wyncote Physical Medicine & Diagnostic PC is a Physical Medicine & Rehabilitation Physician in Wyncote, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2006.

Licensed in
PA
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25 Washington Ln Ste 13C
Wyncote, PA 19095-1400
Phone: (215) 887-5030
Fax: (215) 887-5525
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence MD039601L (PA)

Record details

NPI number1043311764
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amelia Tabuena — Attending Physician · (215) 887-5030
NPI enumeratedSeptember 26, 2006
Last updated in NPPESAugust 22, 2020
Mailing address25 Washington Ln, Ste 13c, Wyncote, PA 19095-1400

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