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Organization

NAZARETH PHYSICIAN SERVICES INC

Active
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Organization

NAZARETH PHYSICIAN SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN J KIRBY (EXECUTIVE DIRECTOR)
(215) 335-6614
Entity
Organization

Contact information

Practice address
1407 RHAWN STREET, PHILADELPHIA, PA 19111
(215) 722-6022
(215) 722-6547
Mailing address
1 W ELM ST, CONSHOHOCKEN, PA 19428-2007
(610) 567-6967
(610) 567-6170

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101465514 0002
—
PA
01
—
2457876003
IBC#
PA
01
—
30029001
KMHP
PA
01
—
425807
AETNA OFFICE #
PA
01
—
NA1775677
BLUE SHIELD
PA
Enumeration date
07/05/2006
Last updated
05/08/2008
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