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Organization
EAST NORRITON PHYSICIANS SERVICES
Active
Organization
EAST NORRITON PHYSICIANS SERVICES
Active
Other names
DeKalb Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
PETER B KENNIFF (CFO)
(610) 292-6522
Entity
Organization
Contact information
Practice address
2525 DEKALB PIKE, NORRISTOWN, PA 19401-2035
(610) 279-2828
(610) 275-0633
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-2007
(610) 567-6967
(610) 567-6170
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100759466
—
PA
01
—
1026335
KMHP
PA
01
—
202264000
OWCP
PA
01
—
2097129000
KHPE
PA
01
—
5178482
AUSHC PPO
PA
01
—
5399
AUSHC HMO
PA
01
—
DE1404878
HIGHMARK BLUE SHIELD
PA
Enumeration date
09/20/2007
Last updated
05/14/2008
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