Provider Demographics
NPI:1205867371
Name:HUNTINGDON VALLEY SURGICAL CONSULTANTS
Entity Type:Organization
Organization Name:HUNTINGDON VALLEY SURGICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-887-3565
Mailing Address - Street 1:1208 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1208 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3706
Practice Address - Country:US
Practice Address - Phone:215-887-3565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025657E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020039062OtherRR MEDICARE/DR. MOORE
PA0532700000OtherKEYSTONE
PA1087030002OtherCIGNA/DR. MOORE
PA0018609380001Medicaid
PA1002111OtherAETNA
PA265028OtherBCBS
PA0012574100008Medicaid
PAC29391Medicare UPIN
PA6684L5VMedicare ID - Type Unspecified
PA0018609380001Medicaid