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General NPI Number Information
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NPI Number | 1588694111
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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 | 07/03/2006
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 1500 LANSDOWNE AVE
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City | DARBY
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State | PA
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Zip | 19023-1200
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Country | US
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Telephone | 610-237-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 41 UNIVERSITY DR STE 300
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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 |
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Authorized Official
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Title or Position | VP, FINANCE AND CFO
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Name | KIMBERLY 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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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