Provider Demographics
NPI:1477545952
Name:WHALEN, ANNE B (DO)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:WHALEN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5526
Mailing Address - Country:US
Mailing Address - Phone:215-845-0735
Mailing Address - Fax:
Practice Address - Street 1:407 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-750-7150
Practice Address - Fax:215-750-7153
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB12173300207Q00000X, 207QG0300X
PAOS008612L207QG0300X
PAOS 008612 L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017082710006Medicaid
PA01708271Medicaid
PAP00926825OtherRAILROAD MEDICARE
PA1482983OtherCIGNA PA
PA5905575OtherAETNA
PA0400375000OtherKEYSTONE IBC
PA30087554OtherKEYSTONE FIRST
PA951546OtherHIGHMARK BLUE SHIELD
PA30087554OtherKEYSTONE FIRST
PA0400375000OtherKEYSTONE IBC