Basic Information
Provider Information
NPI: 1821042508
EntityType: 2
ReplacementNPI:  
OrganizationName: ABINGTON MEMORIAL HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ABINGTON OB/GYN ASSOCIATES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 826594
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191826594
CountryCode: US
TelephoneNumber: 2156578430
FaxNumber: 2156578439
Practice Location
Address1: 300 WELSH RD
Address2: BLDG # 2
City: HORSHAM
State: PA
PostalCode: 190442248
CountryCode: US
TelephoneNumber: 2156578430
FaxNumber: 2156578439
Other Information
ProviderEnumerationDate: 05/19/2006
LastUpdateDate: 10/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WALSH
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: B
AuthorizedOfficialTitleorPosition: SENIOR VP FINANCE
AuthorizedOfficialTelephone: 2154812850
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home