# FORNANCE PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Einstein Physician Montgomery- Ear, Nose & Throat
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144811704
- **Authorized official:** VERA BURNETT-ROBINS (DIRECTOR PHYSICIAN BILLING)
- **Authorized official phone:** (484) 622-7399

## Contact information

- **Practice address:** 210 MALL BLVD STE 202, KING OF PRUSSIA, PA 19406-3260
- **Practice address phone:** (484) 622-1000
- **Mailing address:** PO BOX 789967, PHILADELPHIA, PA 19178-9967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/27/2021
- **Last updated:** 04/14/2021