Organization
FORNANCE PHYSICIAN SERVICES, INC.
Active
Other names
Interventional Associates
Organization subpart
No
Provider details
NPI number
Authorized official
VERA BURNETT-ROBINS (DIRECTOR PHYSICIAN BILLING)
(484) 622-7391
Entity
Organization
Contact information
Practice address
559 W GERMANTOWN PIKE, EAST NORRITON, PA 19403-4250
(484) 622-1365
Mailing address
PO BOX 8500-9967, PHILADELPHIA, PA 19178-9967
(484) 622-7395
(484) 622-7399
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700330901
AMERICHOICE/HMA (UHC MA)
PA
01
—
08722
HEALTH PARTNERS
PA
01
—
1643760
HIGHMARK BLUE SHIELD
PA
05
—
1738323
—
PA
01
—
23-2275591
PHCS
PA
01
—
2319700000
IBC - PC, KHPE
PA
01
—
30026844
KEYSTONE MERCY
PA
01
—
459451
AETNA
PA
Enumeration date
01/20/2006
Last updated
08/17/2018
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