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General NPI Number Information
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NPI Number | 1609260397
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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 | 03/20/2015
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 95 ALMSHOUSE RD SUITE 103
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City | RICHBORO
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State | PA
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Zip | 18954-1154
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Country | US
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Telephone | 215-357-5760
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Fax | 215-357-5731
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Provider Business Mailing Address
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Address Line | 41 UNIVERSITY DR SUITE 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 | 215-710-7037
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Fax | 215-710-5181
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MS. SHARON PROFERA
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Credential |
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Telephone | 215-710-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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