Provider Demographics
NPI:1104017805
Name:HR PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:HR PHYSICIAN SERVICES
Other - Org Name:MEADOWBROOK CARDIOVASCULAR & THORACIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:UROFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-938-2021
Mailing Address - Street 1:1648 HUNTINGDON PIKE
Mailing Address - Street 2:1ST FLOOR BUSINESS OFFICE
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8001
Mailing Address - Country:US
Mailing Address - Phone:215-938-2040
Mailing Address - Fax:215-938-2042
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 208
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8004
Practice Address - Country:US
Practice Address - Phone:215-938-3230
Practice Address - Fax:215-938-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429774208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015313400030Medicaid