Provider Demographics
NPI:1235231291
Name:HEANEY, MADELEINE E (MD)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:E
Last Name:HEANEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 W CHESTER PIKE STE 235
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4291
Mailing Address - Country:US
Mailing Address - Phone:484-420-4660
Mailing Address - Fax:484-420-6547
Practice Address - Street 1:3475 W CHESTER PIKE STE 235
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4291
Practice Address - Country:US
Practice Address - Phone:484-420-4660
Practice Address - Fax:484-420-6547
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429661207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG48448Medicare UPIN