Provider Demographics
NPI:1457349797
Name:NEPHROLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:NEPHROLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOVICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-649-1175
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 130W
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-649-1175
Mailing Address - Fax:610-649-2933
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 130 MEDICAL BUILDING WEST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-1175
Practice Address - Fax:610-649-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007326200002Medicaid
PA074120Medicare PIN