MEDICARE: EAST NORRITON PHYSICIANS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RH0003X	Hematology & Oncology Physician
2	213E00000X	Podiatrist
3	2086S0129X	Vascular Surgery Physician
4	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7467716	OTHER	PA	AUSHC PPO
3	001750894	OTHER	PA	HIGHMARK BLUE SHIELD
4	3985911	OTHER	PA	AUSHC HMO
5	G001162600	OTHER	PA	AMERICHOICE
6	2418384000	OTHER	PA	KHPE
7	30024838	OTHER	PA	KMHP

General Provider Information

NPI Number	:	1316938483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST NORRITON PHYSICIANS SERVICES

Provider Business Mailing Address
First Line	:	1 W ELM ST
Second Line	:	SUITE 100
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2007
Country	:	US
Telephone Number	:	610-567-6967
Fax Number	:	610-567-6170

Provider Business Practice Location Address
First Line	:	2705 DEKALB PIKE
Second Line	:	SUITE 309
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-1852
Country	:	US
Telephone Number	:	610-277-6131
Fax Number	:	610-277-4966

Authorized Official
Title or Position	:	CFO
Name	:	PETER KENNIFF
Credential	:
Telephone Number	:	610-567-6967

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	08/05/2011

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Directions to “EAST NORRITON PHYSICIANS SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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