| Northwestern Medical Associates Pc | |
|
7170 Lafayette Ave Fort Washington PA 19034-2301 | |
| (215) 641-5300 | |
| Not Available |
| Full Name | Northwestern Medical Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7170 Lafayette Ave, Fort Washington, Pennsylvania |
| Authorized Official Name and Position | Richard Jay Leavitt (PRESIDENT) |
| Authorized Official Contact | 2155424343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwestern Medical Associates Pc 589 Skippack Pike Suite 308 Blue Bell PA 19422-2159 Ph: (215) 542-4343 | Northwestern Medical Associates Pc 7170 Lafayette Ave Fort Washington PA 19034-2301 Ph: (215) 641-5300 |
| NPI Number | 1407806003 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8729987243 |
|---|---|
| Medicare Enrollment ID | O20040105000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407806003 | NPI | - | NPPES |
| 0015622660005 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Val R Cantagallo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154386068 PECOS PAC ID: 7719942838 Enrollment ID: I20041130000673 |
| Provider Name | Michael J Naunczek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902859010 PECOS PAC ID: 6901847243 Enrollment ID: I20050518000047 |
| Provider Name | Michael S Rosen |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1619931672 PECOS PAC ID: 1759451412 Enrollment ID: I20080606000309 |
| Provider Name | Richard Leavitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174505739 PECOS PAC ID: 2062311574 Enrollment ID: I20100929000217 |
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