Organization
EAST NORRITON PHYSICIANS SERVICES
Active
Other names
Mercy Medical Associates of Conshohocken
Organization subpart
No
Provider details
NPI number
Authorized official
PETER B KENNIFF (CFO)
(610) 567-6967
Entity
Organization
Contact information
Practice address
500 FAYETTE ST, SUITE 101, CONSHOHOCKEN, PA 19428-1795
(610) 825-3464
(610) 940-4466
Mailing address
1 W ELM ST, SUITE 100, CONSHOHOCKEN, PA 19428-2007
(610) 567-6967
(610) 567-6170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007594660060
—
PA
01
—
2281133001
KHPE
PA
01
—
30012557
KMHP
PA
01
—
5406
AUSHC HMO
PA
01
—
5770514
AUSHC PPO
PA
01
—
ME1599309
HIGHMARK BLUE SHIELD
PA
Enumeration date
10/28/2005
Last updated
03/11/2008
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