Organization
LANGHORNE PHYSICAN SERVICES
Active
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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