Provider Demographics
NPI:1629022231
Name:ABINGTON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ABINGTON MEMORIAL HOSPITAL
Other - Org Name:GLENSIDE MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-481-2850
Mailing Address - Street 1:115 E GLENSIDE AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4618
Mailing Address - Country:US
Mailing Address - Phone:215-572-8944
Mailing Address - Fax:215-572-5036
Practice Address - Street 1:115 E GLENSIDE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4618
Practice Address - Country:US
Practice Address - Phone:215-572-8944
Practice Address - Fax:215-572-5036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA901255Medicare PIN