Healthcare Provider Details

I. General information

NPI: 1316577059
Provider Name (Legal Business Name): TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 LANGHORNE NEWTOWN RD STE 400
LANGHORNE PA
19047-1219
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 215-757-7212
  • Fax: 215-757-7274
Mailing address:
  • Phone: 734-343-2654
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY CUMMINGS
Title or Position: VP, FINANCE AND CFO
Credential:
Phone: 215-710-2508