Organization
EAST NORRITON PHYSICIANS SERVICES
Active
Other names
Blue Bell Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
PETER B KENNIFF (CFO)
(610) 567-6967
Entity
Organization
Contact information
Practice address
725 SKIPPACK PIKE, PAREC PLAZA 2ND FLOOR, BLUE BELL, PA 19422-1741
(215) 542-1300
(215) 643-3123
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-2007
(610) 567-6967
(610) 567-6955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000040925
HIGHMARK BLUE SHIELD
PA
01
—
0019286
AUSHC HMO
PA
01
—
0707702001
KHPE
PA
05
—
1007594660064
—
PA
01
—
202608200
OWCP
PA
01
—
30029546
KMHP
PA
01
—
427
AETNA OFFICE NUMBER
PA
01
—
4422178
AUSHC PPO
PA
Enumeration date
08/26/2005
Last updated
05/08/2008
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