Healthcare Provider Details

I. General information

NPI: 1639126147
Provider Name (Legal Business Name): ASSOCIATED FAMILY PRACTICE PROFESSIONALS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 BROWNSVILLE RD
TREVOSE PA
19053-4668
US

IV. Provider business mailing address

9821 ACADEMY RD
PHILADELPHIA PA
19114-1545
US

V. Phone/Fax

Practice location:
  • Phone: 215-364-1500
  • Fax: 215-364-5140
Mailing address:
  • Phone: 215-632-8700
  • Fax: 215-632-5901

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: MS. BETH A LEVINE
Title or Position: ADMINISTRATOR
Credential:
Phone: 215-355-9065