Basic Information
| Provider Information | |||||||||
| NPI: | 1760408371 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | CONRAD | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1235 OLD YORK RD | ||||||||
| Address2: | STE 121 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155171200 | ||||||||
| FaxNumber: | 2155171219 | ||||||||
| Practice Location | |||||||||
| Address1: | 1235 OLD YORK RD | ||||||||
| Address2: | STE 121 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155171200 | ||||||||
| FaxNumber: | 2155171219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 05/31/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | MD066019L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | MD066019L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 0017412760004 | 05 | PA | MEDICAID |