Healthcare Provider Details

I. General information

NPI: 1831643139
Provider Name (Legal Business Name): APPLEHEART COMMUNITY DEVELOPMENT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BATH RD SUITE 210
BRISTOL PA
19007-3101
US

IV. Provider business mailing address

25 N FELTON ST
PHILADELPHIA PA
19139-2221
US

V. Phone/Fax

Practice location:
  • Phone: 210-310-8087
  • Fax: 866-285-1591
Mailing address:
  • Phone: 215-495-9686
  • Fax: 866-285-1591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD 032354 E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD032354 E
License Number StatePA

VIII. Authorized Official

Name: DR. DEBORAH J MCGREGOR
Title or Position: CHAIR/CEO
Credential: M.D.
Phone: 215-495-9686