1. Home
  2. Directory
  3. Pennsylvania
  4. Philadelphia
  5. Military Health Care Provider
  6. NPI Profile

MRS. PEARL A LAKE
NPI 1053907261
Military Health Care Provider in Philadelphia, PA

Active since December 12, 2020
2214 S 57TH ST, PHILADELPHIA, PA 19143(886) 884-8807(215) 825-5161 Get Directions Write a Review

NPPES record last updated: December 12, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Pearl A Lake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. PEARL A LAKE (NPI 1053907261) is an individual military health care provider provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (7000.000000634RMA) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1053907261
Entity TypeIndividualFemale
Primary Taxonomy171000000X
Provider Legal NameMRS. PEARL A LAKE
Location Address2214 S 57TH STPhiladelphia, PA 19143-5705
Mailing Address2250 E Monmouth StPhiladelphia, PA 19134-4103 · (267) 884-8807 · Fax (215) 825-5161
Phone(886) 884-8807
Fax(215) 825-5161
Sole ProprietorYes
Enumeration DateDecember 12, 2020
NPPES CertifiedDecember 12, 2020
✔ NPI 1053907261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care ProviderOther Service Providers
Taxonomy Code171000000X
Licenses✔ Licensed in PA · 7000.000000634RMA✔ Licensed in PA · 70000634RMA
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
2214 S 57TH ST, Philadelphia, PA 19143
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEST CARE ONE LLC
Custodial Care Facility (Adult Care Home)
2214 S 57TH ST
PHILADELPHIA, PA 19143
Philadelphia County (267) 428-9500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pearl Lake's NPI number?

The NPI number for Pearl Lake is 1053907261. It was assigned to this individual provider in the NPPES registry on December 12, 2020.

Where is Pearl Lake located?

Pearl Lake practices at 2214 S 57th St, Philadelphia, PA 19143. The listed phone number is (886) 884-8807.

What is Pearl Lake's specialty?

The primary specialty registered for this NPI is Military Health Care Provider with taxonomy code 171000000X.

When was this NPI record last updated?

The NPPES record for Pearl Lake was last updated on December 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.