Basic Information
| Provider Information | |||||||||
| NPI: | 1669676797 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TENTHOFF | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | CATHLEEN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WIEDMANN | ||||||||
| OtherFirstName: | ANNE | ||||||||
| OtherMiddleName: | TENTHOFF | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1235 OLD YORK RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156593220 | ||||||||
| FaxNumber: | 2156598967 | ||||||||
| Practice Location | |||||||||
| Address1: | 1235 OLD YORK RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156593220 | ||||||||
| FaxNumber: | 2156598967 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 04/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD183603 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.