MEDICARE: NAZARETH PHYSICIAN SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RC0001X	Clinical Cardiac Electrophysiology Physician
2	207RI0011X	Interventional Cardiology Physician
3	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1285150458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAZARETH PHYSICIAN SERVICES, INC.

Provider Business Mailing Address
First Line	:	41 UNIVERSITY DR STE 300
Second Line	:
City	:	NEWTOWN
State	:	PA
Zip	:	18940-1873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 HOLME AVE STE 200
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19152-3004
Country	:	US
Telephone Number	:	215-335-3972
Fax Number	:	215-335-3784

Authorized Official
Title or Position	:	PRESIDENT, MEDICAL GROUP
Name	:	AMIT POWAR
Credential	:
Telephone Number	:	215-710-6573

Provider Enumeration Date	:	08/18/2017
Last Update Date	:	05/02/2023

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