MEDICARE: ABS MEDICINE LLC

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
1	207K00000X	Allergy & Immunology Physician	MD430551	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730587486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABS MEDICINE LLC

Provider Business Mailing Address
First Line	:	704 S BROAD ST
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-5242
Country	:	US
Telephone Number	:	267-416-0212
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 S BROAD ST
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-5242
Country	:	US
Telephone Number	:	267-416-0212
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ALYSON BETH SIMPSON
Credential	:	MD
Telephone Number	:	856-341-3902

Provider Enumeration Date	:	12/11/2014
Last Update Date	:	02/25/2015

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Directions to “ABS MEDICINE LLC ” Practice Location

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