Healthcare Provider Details

I. General information

NPI: 1588118236
Provider Name (Legal Business Name): LANGHORNE PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2562 KNIGHTS RD
BENSALEM PA
19020-3407
US

IV. Provider business mailing address

41 UNIVERSITY DR SUITE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 215-244-6363
  • Fax: 215-244-6365
Mailing address:
  • Phone: 215-710-7037
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARON PROFERA
Title or Position: INTERIN CFO
Credential:
Phone: 215-710-2013