Provider Demographics
NPI:1558316109
Name:EINSTEIN COMMUNITY HEALTH ASSOCIATES, INC
Entity Type:Organization
Organization Name:EINSTEIN COMMUNITY HEALTH ASSOCIATES, INC
Other - Org Name:ECHA FAMILY MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERVISOR, ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-456-4694
Mailing Address - Street 1:101 E OLNEY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2421
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-254-3289
Practice Address - Street 1:101 E OLNEY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19120-2421
Practice Address - Country:US
Practice Address - Phone:215-456-7000
Practice Address - Fax:215-254-3289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA581487OtherHIGHMARK BLUE SHIELD
PA581487OtherHIGHMARK BLUE SHIELD