MEDICARE: MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner
2	310400000X	Assisted Living Facility	114350	PA
3	314000000X	Skilled Nursing Facility	09130200	PA
4	251G00000X	Community Based Hospice Care Agency	17001601	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	39-1700	OTHER	PA	MEDICARE HOSPICE (CAHABA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	006341	OTHER	PA	INDEPENDENCE BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	39010	OTHER	PA	EVERCARE UNITED HEALTH

General Provider Information

NPI Number	:	1598752206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE

Provider Business Mailing Address
First Line	:	1425 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-371-3000
Fax Number	:	215-371-3032

Provider Business Practice Location Address
First Line	:	1425 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-371-3000
Fax Number	:	215-371-3032

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	ANDY BRONSTEIN
Credential	:	CPA
Telephone Number	:	215-371-1807

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	08/26/2010

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Directions to “MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE ” Practice Location

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