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General NPI Number Information
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NPI Number | 1063830669
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1057 SECOND STREET PIKE
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City | RICHBORO
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State | PA
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Zip | 18954-1803
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Country | US
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Telephone | 215-710-2770
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Fax | 215-710-2772
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Provider Business Mailing Address
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Address Line | 41 UNIVERSITY DR 3RD FLOOR
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City | NEWTOWN
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State | PA
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Zip | 18940-1873
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Country | US
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Telephone | 734-343-2654
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Fax | 215-710-5181
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Authorized Official
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Title or Position | VP, FINANCE AND CFO
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Name | KIMBERLY A CUMMINGS
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Credential |
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Telephone | 215-710-2508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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