Healthcare Provider Details

I. General information

NPI: 1952330805
Provider Name (Legal Business Name): ABINGTON MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 BLAIR MILL ROAD NORTHWOOD SUITE E
WILLOW GROVE PA
19090
US

IV. Provider business mailing address

PO BOX 826594
PHILADELPHIA PA
19182-6594
US

V. Phone/Fax

Practice location:
  • Phone: 215-672-5108
  • Fax:
Mailing address:
  • Phone: 215-672-5108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number270501
License Number StatePA

VIII. Authorized Official

Name: MICHAEL WALSH
Title or Position: VICE-PRESIDENT
Credential:
Phone: 215-481-2850