Provider Demographics
NPI:1083628820
Name:HUNTINGDON VALLEY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:HUNTINGDON VALLEY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-947-1470
Mailing Address - Street 1:2352 PHILMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6228
Mailing Address - Country:US
Mailing Address - Phone:215-947-1470
Mailing Address - Fax:215-947-0904
Practice Address - Street 1:2352 PHILMONT AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6228
Practice Address - Country:US
Practice Address - Phone:215-947-1470
Practice Address - Fax:215-947-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026348E261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care