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Organization
TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Active
Organization
TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Active
Other names
St. Mary Family Practice - Richboro
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON PROFERA (ADMINISTRATIVE DIRECTOR)
(215) 710-2013
Entity
Organization
Contact information
Practice address
95 ALMSHOUSE RD, SUITE 103, RICHBORO, PA 18954-1154
(215) 357-5760
(215) 357-5731
Mailing address
41 UNIVERSITY DR, SUITE 300, NEWTOWN, PA 18940-1873
(215) 710-7037
(215) 710-5181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007497370052
—
PA
01
—
30212269
KEYSTONE FIRST
PA
01
—
3156947
HIGHMARK BLUE SHIELD
PA
01
—
3920999003
KEYSTONE IBC
PA
01
—
4196193
AETNA
PA
01
—
CA4059
RAILROAD MEDICARE
PA
Enumeration date
03/20/2015
Last updated
12/27/2023
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