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1665 Bustleton Pike Feasterville PA 19053-7305 | |
(215) 355-9770 | |
(215) 355-2246 |
Full Name | |
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Speciality | Family Medicine |
Location | 1665 Bustleton Pike, Feasterville, Pennsylvania |
Authorized Official Name and Position | Michael B Walsh (SENIOR VP FINANCE) |
Authorized Official Contact | 2154812850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 826594 Philadelphia PA 19182-6594 Ph: (215) 355-9770 | 1665 Bustleton Pike Feasterville PA 19053-7305 Ph: (215) 355-9770 |
NPI Number | 1821042912 |
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Provider Enumeration Date | 05/22/2006 |
Last Update Date | 10/10/2022 |
Medicare PECOS PAC ID | 3274437736 |
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Medicare Enrollment ID | O20040114000271 |
Identifier | Type | State | Issuer |
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1821042912 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Steven M Rosenberg |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1083610471 PECOS PAC ID: 4486555711 Enrollment ID: I20040119000511 |
Provider Name | John Peniston |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265438642 PECOS PAC ID: 2365343605 Enrollment ID: I20040119000545 |
Provider Name | Susan Pak Lee |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093711574 PECOS PAC ID: 8921909268 Enrollment ID: I20040119000575 |
Provider Name | Courtney Harrigan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508111303 PECOS PAC ID: 3274852199 Enrollment ID: I20150427002127 |
Provider Name | Lisa Marie Scaccetti |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366745200 PECOS PAC ID: 0749598696 Enrollment ID: I20150928000039 |
Provider Name | Wayne Wing Fai Li |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538589288 PECOS PAC ID: 4587934724 Enrollment ID: I20180910001166 |
Thomas Duffield, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Bustleton Pike, Suite 9, Feasterville, PA 19053 Phone: 267-225-2975 Fax: 866-973-9701 | |