# FORNANCE PHYSICIAN SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Interventional Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225018526
- **Authorized official:** VERA BURNETT-ROBINS (DIRECTOR PHYSICIAN BILLING)
- **Authorized official phone:** (484) 622-7391

## Contact information

- **Practice address:** 559 W GERMANTOWN PIKE, EAST NORRITON, PA 19403-4250
- **Practice address phone:** (484) 622-1365
- **Mailing address:** PO BOX 8500-9967, PHILADELPHIA, PA 19178-9967
- **Mailing address phone:** (484) 622-7395
- **Mailing address fax:** (484) 622-7399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/20/2006
- **Last updated:** 08/17/2018