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General NPI Number Information
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NPI Number | 1104763861
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Entity Type | Organization
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Legal Business Name | AVANTA PRIMARY CARE, P.C.
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 300 WELSH RD STE 100
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City | HORSHAM
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State | PA
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Zip | 19044-2248
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Country | US
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Telephone | 267-703-5900
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Fax | 267-703-2671
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Provider Business Mailing Address
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Address Line | 3956 AMBERTON CT
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City | DOYLESTOWN
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State | PA
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Zip | 18902-1242
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Country | US
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Telephone | 267-703-5900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALENA BLAIN
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Credential | NP
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Telephone | 917-388-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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