Basic Information
| Provider Information | |||||||||
| NPI: | 1487028262 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ABINGTON MEMORIAL HOSPITAL | ||||||||
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| OtherOrganizationName: | ABINGTON PULMONARY AND CRITICAL CARE ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 826594 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191826594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155171200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 686 DEKALB PIKE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194221258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155171200 | ||||||||
| FaxNumber: | 2155171219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2015 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| AuthorizedOfficialLastName: | WALSH | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 2154812850 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | PA | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 207RP1001X | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.