Provider Demographics
NPI:1922191097
Name:LING, HENRY T (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:T
Last Name:LING
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:MOB WEST STE 140
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096
Mailing Address - Country:US
Mailing Address - Phone:610-642-6990
Mailing Address - Fax:610-642-6723
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:MOB WEST STE 140
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096
Practice Address - Country:US
Practice Address - Phone:610-642-6990
Practice Address - Fax:610-642-6723
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041017E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
092169Medicare ID - Type Unspecified
E12863Medicare UPIN