Organization
EAST NORRITON PHYSICIANS SERVICES
Active
Other names
Colonial Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
PETER B KENNIFF (CFO)
(610) 567-6967
Entity
Organization
Contact information
Practice address
1982 BUTLER PIKE, SUITE 2, CONSHOHOCKEN, PA 19428-3701
(610) 260-0888
(610) 260-0898
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-4108
(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
—
0016855148
HIGHMARK BLUE SHIELD
PA
01
—
040290
AUSHC OFFICE NUMBER
PA
05
—
1007594660061
—
PA
01
—
1532049
CIGNA
PA
01
—
2361114001
KHPE
PA
01
—
30022005
KMHP
PA
01
—
596261
AUSHC HMO
PA
01
—
7325222
AUSHC PPO
PA
Enumeration date
09/14/2005
Last updated
03/11/2008
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