Healthcare Provider Details

I. General information

NPI: 1740860089
Provider Name (Legal Business Name): TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4595 NEW FALLS RD STE A
LEVITTOWN PA
19056-3004
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 267-587-3700
  • Fax: 215-949-2650
Mailing address:
  • Phone: 734-343-2654
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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