Provider Demographics
NPI:1932154309
Name:HUNTINGDON VALLEY PULMONARY CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:HUNTINGDON VALLEY PULMONARY CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-663-9095
Mailing Address - Street 1:930B HENRIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-8502
Mailing Address - Country:US
Mailing Address - Phone:215-663-9095
Mailing Address - Fax:
Practice Address - Street 1:930B HENRIETTA AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-8502
Practice Address - Country:US
Practice Address - Phone:215-663-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-026331E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001755164-0002Medicaid
06108OtherELDER HEALTH
PA26306OtherSENIOR PARTNERS
PA1097866OtherKEYSTONE MERCY
2122881OtherAETNA
NJ8250201OtherUNISYS
2Y20668OtherHEALTH NET
G2471789OtherOXFORD
PA095148OtherPERSONAL CHOICE
PA0313850000OtherINDEPENDENCE BLUE CROSEE
26306OtherHEALTH PARTNERS
PA001755164-0002Medicaid