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Organization

EAST NORRITON PHYSICIANS SERVICES

Active
Other names
Mercy Family Medicine of East Norriton
Organization subpart
No

Provider details

NPI number
Authorized official
PETER B KENNIFF (CFO)
(610) 567-6967
Entity
Organization

Contact information

Practice address
190 W GERMANTOWN PIKE, SUITE 110, EAST NORRITON, PA 19401-1385
(610) 272-0190
(610) 272-4428
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-4108
(610) 567-6967
(610) 567-6170

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007594660066
PA
01
2025321
HIGHMARK BLUE SHIELD
PA
01
30050608
KEYSTONE MERCY
PA
01
3424972001
IBC/KHPE
PA
Enumeration date
03/03/2008
Last updated
03/10/2010
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