Provider Demographics
NPI:1093756462
Name:DR.STANFORD A. SHOR ASSOCIATES
Entity Type:Organization
Organization Name:DR.STANFORD A. SHOR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STANFORD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-328-4460
Mailing Address - Street 1:61 S MORTON AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MORTON
Mailing Address - State:PA
Mailing Address - Zip Code:19070-1740
Mailing Address - Country:US
Mailing Address - Phone:610-328-4460
Mailing Address - Fax:610-328-6178
Practice Address - Street 1:61 S MORTON AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1740
Practice Address - Country:US
Practice Address - Phone:610-328-4460
Practice Address - Fax:610-328-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC06101948OtherELDER CARE
PACM9796OtherPALMETTOGBA
PAPA3532OtherQUALMED
PA116669800OtherUS DEPARTMENT OF LABOR
PA211275OtherCOVENTRY (HEALTH AMERICA)
PA6115087AOtherCIGNA
PA0406850001OtherHMO ID
PA0000040OtherAETNA
PA288830OtherMAMSI
PA000598510OtherHIGHMARK BLUE SHIELD ID
PA6115087AOtherCIGNA