Healthcare Provider Details

I. General information

NPI: 1477863348
Provider Name (Legal Business Name): EMMELINE P. ABELLA,MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 LANGHORNE NEWTOWN RD SUITE 108
LANGHORNE PA
19047-1219
US

IV. Provider business mailing address

1290 VALLEY RD
RYDAL PA
19046-1248
US

V. Phone/Fax

Practice location:
  • Phone: 215-947-3882
  • Fax: 215-355-7614
Mailing address:
  • Phone: 215-947-3882
  • Fax: 215-355-7614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD034690L
License Number StatePA

VIII. Authorized Official

Name: MARY VITO
Title or Position: OFFICE MANAGER
Credential:
Phone: 215-947-3882