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General NPI Number Information
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NPI Number | 1366949646
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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 | 04/12/2018
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 1205 LANGHORNE NEWTOWN RD STE 302
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City | LANGHORNE
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State | PA
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Zip | 19047-1222
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Country | US
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Telephone | 215-710-5812
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Fax | 215-710-6801
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Provider Business Mailing Address
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Address Line | 1201 LANGHORNE NEWTOWN RD MAIL ROOM
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City | LANGHORNE
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State | PA
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Zip | 19047-1201
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Country | US
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Telephone | 215-710-5522
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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 | JULIE KEESE
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Credential |
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Telephone | 301-754-7201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | PA
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