MEDICARE: HR PHYSICIAN SVCS

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	207V00000X	Obstetrics & Gynecology Physician		PA

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

General Provider Information

NPI Number	:	1831199215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HR PHYSICIAN SVCS

Provider Business Mailing Address
First Line	:	1648 HUNTINGDON PIKE
Second Line	:	1ST FLOOR BUSINESS OFFICE
City	:	MEADOWBROOK
State	:	PA
Zip	:	19046-8001
Country	:	US
Telephone Number	:	215-938-2040
Fax Number	:	215-938-2042

Provider Business Practice Location Address
First Line	:	7901 BUSTLETON AVE
Second Line	:	SUITE 100
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3328
Country	:	US
Telephone Number	:	215-742-7890
Fax Number	:	215-742-7862

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	MRS. MICHELLE URSOFSKY
Credential	:
Telephone Number	:	215-938-2021

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	12/06/2007

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