Provider Demographics
NPI:1417980954
Name:NEPHROLOGY & HYPERTENSION ASSOCIATES PC
Entity Type:Organization
Organization Name:NEPHROLOGY & HYPERTENSION ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGAETANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-757-5772
Mailing Address - Street 1:240 MIDDLETOWN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1816
Mailing Address - Country:US
Mailing Address - Phone:215-757-5772
Mailing Address - Fax:215-757-5494
Practice Address - Street 1:240 MIDDLETOWN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1816
Practice Address - Country:US
Practice Address - Phone:215-757-5772
Practice Address - Fax:215-757-5494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014731930005Medicaid
PA0014731930005Medicaid