Provider Demographics
NPI:1699353920
Name:HOME VISITING PHYSICIANS PC
Entity Type:Organization
Organization Name:HOME VISITING PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-771-7277
Mailing Address - Street 1:2017 BALLANTINE LN
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2738
Mailing Address - Country:US
Mailing Address - Phone:215-233-9842
Mailing Address - Fax:215-233-9488
Practice Address - Street 1:2017 BALLANTINE LN
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2738
Practice Address - Country:US
Practice Address - Phone:215-233-9842
Practice Address - Fax:215-233-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty