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General NPI Number Information
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NPI Number | 1871025924
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Entity Type | Organization
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Legal Business Name | ABRAMSON CENTER FOR JEWISH LIFE MEDICAL GROUP
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 135 S BRYN MAWR AVE SUITE 110
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City | BRYN MAWR
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State | PA
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Zip | 19010-3106
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Country | US
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Telephone | 215-371-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 HORSHAM RD
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City | NORTH WALES
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State | PA
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Zip | 19454-1320
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Country | US
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Telephone | 215-371-3000
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MARK WASSERMAN
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Credential |
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Telephone | 215-371-3000
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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 | 363LP2300X
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Taxonomy Name | Primary Care 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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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