Healthcare Provider Details

I. General information

NPI: 1760711998
Provider Name (Legal Business Name): TEMPLE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 LANGHORNE NEWTOWN RD SUITE 106
LANGHORNE PA
19047-1219
US

IV. Provider business mailing address

2450 W HUNTING PARK AVE 2ND TPI ATTN: D KESSLER
PHILA PA
19129-1302
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-3140
  • Fax: 215-757-5870
Mailing address:
  • Phone: 215-926-9022
  • Fax: 215-226-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERIC MANKIN
Title or Position: CEO
Credential: MD
Phone: 215-926-9050