Provider Demographics
NPI:1598752206
Name:MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE
Entity Type:Organization
Organization Name:MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:215-371-1807
Mailing Address - Street 1:1425 HORSHAM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1320
Mailing Address - Country:US
Mailing Address - Phone:215-371-3000
Mailing Address - Fax:215-371-3032
Practice Address - Street 1:1425 HORSHAM RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1320
Practice Address - Country:US
Practice Address - Phone:215-371-3000
Practice Address - Fax:215-371-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17001601251G00000X
PA114350310400000X
PA09130200314000000X
363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA006341OtherINDEPENDENCE BLUE CROSS
PA1007600910035Medicaid
PA39-1700OtherMEDICARE HOSPICE (CAHABA)
PA1007600910039Medicaid
PA39010OtherEVERCARE UNITED HEALTH
PA39010OtherEVERCARE UNITED HEALTH
PA396078Medicare ID - Type Unspecified
PA039191Medicare ID - Type UnspecifiedHIGHMARK MEDICARE (DOCS)