1447671243 NPI number — NAZARETH PHYSICIANS SERVICES, INC

Table of content: (NPI 1447671243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447671243 NPI number — NAZARETH PHYSICIANS SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAZARETH PHYSICIANS SERVICES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447671243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 W ELM ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
CONSHOHOCKEN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19428-4108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-567-5265
Provider Business Mailing Address Fax Number:
610-567-6955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2701 HOLME AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19152-2029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-331-3871
Provider Business Practice Location Address Fax Number:
215-331-3872
Provider Enumeration Date:
12/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HUROWITZ
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP PHYS PRAC MGMT MHS
Authorized Official Telephone Number:
610-567-5236

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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