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Organization
MAIN LINE HEALTHCARE
Active
Organization
MAIN LINE HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNA FOOTE (MANAGER)
(484) 337-1667
Entity
Organization
Contact information
Practice address
3803 WEST CHESTER PIKE, H BLDG SUITE 160, NEWTOWN SQUARE, PA 19073-2333
(484) 337-1585
(484) 337-1410
Mailing address
3803 W CHESTER PIKE, H BLDG SUITE 160, NEWTOWN SQUARE, PA 19073-2333
(484) 337-1585
(484) 337-1410
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
PA
207RH0003X
Hematology & Oncology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
PA
207VX0201X
Gynecologic Oncology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
PA
208C00000X
Colon & Rectal Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208M00000X
Hospitalist Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007723500075
—
PA
05
—
1007723500121
—
PA
Enumeration date
03/15/2006
Last updated
04/21/2021
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