Basic Information
| Provider Information | |||||||||
| NPI: | 1225128192 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UHS OF PENNSYLVANIA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 722 E BUTLER PIKE | ||||||||
| Address2: | |||||||||
| City: | AMBLER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190022310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105241552 | ||||||||
| FaxNumber: | 6105246039 | ||||||||
| Practice Location | |||||||||
| Address1: | 722 E BUTLER PIKE | ||||||||
| Address2: | |||||||||
| City: | AMBLER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190022310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105241552 | ||||||||
| FaxNumber: | 6105246039 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CHAVEZ | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6105241552 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 0861509000 | 01 | PA | PERSONNAL CHOICE | OTHER | CD9539 | 01 | PA | RAILROAD MEDICARE | OTHER | 1007285950065 | 05 | PA | MEDICAID |