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General NPI Number Information
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NPI Number | 1760794846
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Entity Type | Organization
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Legal Business Name | MONTGOMERY HOSPITAL
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 1330 POWELL ST MONTGOMERY PROFESSIONAL BUILDING SUITE 409
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City | NORRISTOWN
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State | PA
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Zip | 19401-3353
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Country | US
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Telephone | 610-277-0964
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 GREENWOOD AVE APT 608
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City | JENKINTOWN
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State | PA
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Zip | 19046-2901
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Country | US
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Telephone | 267-616-3681
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DR. HAZEL BLUESTEIN
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Credential |
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Telephone | 610-277-0964
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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 | MT196847
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License Number State | PA
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