Provider Demographics
NPI:1588628176
Name:CHESTNUT HILL EMERGENCY ASSOCIATES LTD
Entity type:Organization
Organization Name:CHESTNUT HILL EMERGENCY ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ELIOT
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-248-8523
Mailing Address - Street 1:PO BOX 41555
Mailing Address - Street 2:CHESTNUT HILL EMERGENCY ASSOCIATES LTD
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19101
Mailing Address - Country:US
Mailing Address - Phone:800-777-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:8835 GERMANTOWN AVE
Practice Address - Street 2:CHESTNUT HILL HOSPITAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118
Practice Address - Country:US
Practice Address - Phone:215-248-8523
Practice Address - Fax:215-248-8275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA082586OtherHIGHMARK BS
PA0007345170005Medicaid
PA0060199000OtherINDEPENDENCE BC
PA082586Medicare ID - Type Unspecified