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General NPI Number Information
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NPI Number | 1518567106
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Entity Type | Organization
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Legal Business Name | PROHEALTH ASSOCIATES LLC
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Dates
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Enumeration Date | 10/31/2020
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Last Update Date | 10/31/2020
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Provider Practice Location Address
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Address Line | 296 AMES CIR
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-7976
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Country | US
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Telephone | 267-738-0576
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Fax |
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Provider Business Mailing Address
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Address Line | 296 AMES CIR
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-7976
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Country | US
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Telephone | 267-738-0576
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ANITHA GEORGE
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Credential | CRNP
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Telephone | 267-738-0576
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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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