Organization
FORNANCE PHYSICIAN SERVICES, INC
Active
Other names
Conshohocken Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
VERA BURNETTROBINS (DIRECTOR PHYSICIAN BILLING)
(484) 622-7391
Entity
Organization
Contact information
Practice address
612 FAYETTE ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-1797
(610) 828-8500
(610) 828-9736
Mailing address
PO BOX 789967, PHILADELPHIA, PA 19178-9967
(484) 622-7395
(484) 622-7399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000059
AETNA HMO
PA
01
—
0282527
CIGNA HMO/PPO
PA
01
—
05657970001
IBC - PC/KHPE
PA
01
—
0565797001
AMERICHOICE/INTERCOUNTY
PA
01
—
1021702
KEYSTONE MERCY
PA
01
—
17213
SITE# FOR HEALTH PARTNERS
PA
01
—
4439611
AETNA PPO
PA
01
—
727928
HIGHMARK BLUE SHIELD
PA
01
—
CC5657
RRM
PA
Enumeration date
05/23/2006
Last updated
11/15/2018
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