| Nazareth Physician Services Inc | |
|
2601 Holme Ave Philadelphia PA 19152-2007 | |
| (215) 350-7417 | |
| (215) 335-6303 |
| Full Name | Nazareth Physician Services Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2601 Holme Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | David Wajda (CFO) |
| Authorized Official Contact | 2153356614 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nazareth Physician Services Inc 1 W Elm St Suite 100 Conshohocken PA 19428-4108 Ph: (610) 567-6967 | Nazareth Physician Services Inc 2601 Holme Ave Philadelphia PA 19152-2007 Ph: (215) 350-7417 |
| NPI Number | 1538190137 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 04/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538190137 | NPI | - | NPPES |
| 2457876000 | Other | PA | IBC# |
| 101465514 0001 | Medicaid | PA | |
| NA1775677 | Other | PA | HIGHMARK BLUE SHIELD |
| 425807 | Other | PA | AETNA OFFICE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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