Provider Demographics
NPI:1669412896
Name:BENSALEM MEDICAL PRACTICE, P.C.
Entity type:Organization
Organization Name:BENSALEM MEDICAL PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:GRAHAM
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:215-752-1810
Mailing Address - Street 1:2373 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-6000
Mailing Address - Country:US
Mailing Address - Phone:215-752-1810
Mailing Address - Fax:215-752-1060
Practice Address - Street 1:2373 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-6000
Practice Address - Country:US
Practice Address - Phone:215-752-1810
Practice Address - Fax:215-752-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA049202Medicare ID - Type Unspecified