Provider Demographics
NPI:1508699364
Name:VIA AFFILIATES
Entity type:Organization
Organization Name:VIA AFFILIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-370-5296
Mailing Address - Street 1:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9641
Mailing Address - Country:US
Mailing Address - Phone:267-370-5285
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:599 W STATE ST STE 307
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2567
Practice Address - Country:US
Practice Address - Phone:215-345-2489
Practice Address - Fax:215-489-7233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty