Organization
LANGHORNE PHYSICAN SERVICES
Active
Other names
Mercy Orthopedic Group
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY DOMINIC FANELLI (VP, REGIONAL FINANCIAL REPORTING)
(610) 886-6674
Entity
Organization
Contact information
Practice address
2821 ISLAND AVE, SUITE 147, PHILADELPHIA, PA 19153-2300
(610) 626-9800
(610) 626-8856
Mailing address
41 UNIVERSITY DR STE 106, NEWTOWN, PA 18940-1873
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007787930170
—
PA
01
—
1893659
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/04/2007
Last updated
01/24/2023
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