Provider Demographics
NPI:1356429310
Name:PENN FAMILY MEDICINE
Entity type:Organization
Organization Name:PENN FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHORSCHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-898-9200
Mailing Address - Street 1:639 WYNONAH DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:PA
Mailing Address - Zip Code:17922-9402
Mailing Address - Country:US
Mailing Address - Phone:610-898-9200
Mailing Address - Fax:610-898-9188
Practice Address - Street 1:4885 DEMOSS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9023
Practice Address - Country:US
Practice Address - Phone:610-898-9200
Practice Address - Fax:610-898-9188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05-009487-L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0731031000OtherINDIV. ID DHPE
PA01168001OtherINDIV. ID BLUE CROSS
PA280998OtherMAMSI
PA02338600OtherCAPITAL BLUE CROSS
PA1708315OtherMEDICAL ASSISTANCE
PA4535653OtherAETNA PPO
PA977114OtherINDIV. ID KHPC & SENIOR B
PA000000125507OtherUNISON/THREE RIVERS PROV
PA0721895001OtherGROUP ID KHPE
PA080170263OtherRR MEDICARE PIN
PA346961OtherBLUE SHIELD
PA59548 S1DFOtherGELSINGER IND PIN
PASC977114OtherHIGHMARK PROVIDER ID
PA59548 S1DFOtherGELSINGER IND PIN
PA02338600OtherCAPITAL BLUE CROSS
PA013433Medicare ID - Type Unspecified