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NPI Code Detail

MEDICARE: TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP

MEDICARE: TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1639039175
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Provider Business Mailing Address
First Line : 41 UNIVERSITY DR STE 300
Second Line :
City : NEWTOWN
State : PA
Zip : 18940-1873
Country : US
Telephone Number : 610-772-6889
Fax Number : 215-350-7410
Provider Business Practice Location Address
First Line : 2601 HOLME AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-2007
Country : US
Telephone Number : 215-335-6562
Fax Number : 215-350-7410
Authorized Official
Title or Position : VP, FINANCE AND CFO
Name : JULIE KEESE
Credential :
Telephone Number : 301-754-7201
Provider Enumeration Date : 11/17/2025
Last Update Date : 03/13/2026

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Directions to “TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP ” Practice Location

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