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NPI 1043013246 Active Family Medicine

Quick Facts

NPI Number

1043013246

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2025-03-31

Last Updated (NPPES)

2025-10-28

Primary Specialty / Taxonomy

Taxonomy	Family Medicine
Taxonomy Code	`207Q00000X`

Practice Address

3 BALA PLZ W STE 200
BALA CYNWYD, PA 190043478

Phone: 215-292-6966

Mailing Address

PO BOX 23736
NASHVILLE, TN 372023736

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.