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General NPI Number Information
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NPI Number | 1588489272
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Entity Type | Organization
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Legal Business Name | VIA AFFILIATES
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 847 EASTON RD STE 2900
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City | WARRINGTON
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State | PA
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Zip | 18976-2908
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Country | US
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Telephone | 267-864-0020
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Fax | 267-864-0021
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Provider Business Mailing Address
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Address Line | PO BOX 8298641
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City | PHILADELPHIA
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State | PA
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Zip | 19182-9641
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Country | US
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Telephone | 267-370-5296
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Fax | 215-230-3725
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Authorized Official
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Title or Position | REVENUE CYCLE DIRECTOR
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Name | KRISTIN JAYNE
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Credential |
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Telephone | 267-370-5296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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