Healthcare Provider Details

I. General information

NPI: 1154650489
Provider Name (Legal Business Name): ABINGTON MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 01/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 FORT WASHINGTON AVE SUITE E
FORT WASHINGTON PA
19034-1743
US

IV. Provider business mailing address

1244 FORT WASHINGTON AVE SUITE E
FORT WASHINGTON PA
19034-1743
US

V. Phone/Fax

Practice location:
  • Phone: 215-646-1686
  • Fax: 215-628-4596
Mailing address:
  • Phone: 215-646-1686
  • Fax: 215-628-4596

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: JACK KELLY
Title or Position: CHIEF OF STAFF
Credential: M.D.
Phone: 215-481-2600