Provider Demographics
NPI:1417920026
Name:DELAWARE VALLEY NEPHROLOGY AND HYPERTENSION ASSOC PC
Entity Type:Organization
Organization Name:DELAWARE VALLEY NEPHROLOGY AND HYPERTENSION ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELHAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:267-385-5538
Mailing Address - Street 1:10 E MORELAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3541
Mailing Address - Country:US
Mailing Address - Phone:267-385-5538
Mailing Address - Fax:267-437-3176
Practice Address - Street 1:10 E MORELAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3541
Practice Address - Country:US
Practice Address - Phone:267-385-5538
Practice Address - Fax:267-437-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0076885000OtherKEYSTONE HEALTH PLAN EAST
PACA1374OtherRAILROAD MEDICARE
PA0076885000OtherPERSONAL CHOICE
PA077146OtherHIGHMARK BLUE SHIELD
PA1002934OtherKEYSTONE MERCY
PA12945OtherHEALTH PARTNERS
PA0015398110006Medicaid
PA94599OtherAETNA
PA077146Medicare PIN