Basic Information
| Provider Information | |||||||||
| NPI: | 1528403904 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABINGTON MEMORIAL HOSPITAL | ||||||||
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| OtherOrganizationName: | ABINGTON SURGICAL ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 826594 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191826594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154813918 | ||||||||
| FaxNumber: | 2154816790 | ||||||||
| Practice Location | |||||||||
| Address1: | 1245 HIGHLAND AVE | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154817462 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2013 | ||||||||
| LastUpdateDate: | 10/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | WALSH | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 2154812000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD434663 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.