Provider Demographics
NPI:1619929775
Name:MEDICAL ASSOCIATES OF DREXEL HILL, INC.
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF DREXEL HILL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-736-4850
Mailing Address - Street 1:100 W SPROUL RD STE 224
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2033
Mailing Address - Country:US
Mailing Address - Phone:610-789-6320
Mailing Address - Fax:484-471-3917
Practice Address - Street 1:510 WEST DARBY ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:610-789-6320
Practice Address - Fax:610-789-6325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007156920001Medicaid
PA0031212000OtherINDEPENDENCE BLUE CROSS
PA004842OtherAETNA
PA02191OtherHEALTH PARTNERS
PA039509OtherHIGHMARK BLUE SHIELD
PA30926OtherKEYSTONE MERCY
PA02191OtherHEALTH PARTNERS
PA039509OtherHIGHMARK BLUE SHIELD