Healthcare Provider Details

I. General information

NPI: 1700218989
Provider Name (Legal Business Name): NORTHSTAR ANESTHESIA OF PENNSYLVANIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LANSDOWNE AVE
DARBY PA
19023-1200
US

IV. Provider business mailing address

PO BOX 612625
DALLAS TX
75261-2625
US

V. Phone/Fax

Practice location:
  • Phone: 610-237-4000
  • Fax: 817-856-0655
Mailing address:
  • Phone: 239-610-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA L LUMBLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 214-783-2064