NPIMap

Organization Active NPI

Nazareth Physician Services Inc

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1265682082
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NAZARETH PHYSICIAN SERVICES INC
Practice address
3461 Cottman Ave
Philadelphia, PA 19149-1605
Phone
(215) 624-6007
Fax
(215) 624-6465
NPI assigned
Sep 29, 2008
Last updated
Apr 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Wajda
Title
VP Finance
Phone
(215) 335-6043

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

3461 Cottman Ave
Philadelphia, PA 19149-1605

Mailing address

1 W Elm St
Suite 100
Conshohocken, PA 19428-4108
Phone (610) 567-5513

National Provider Directory

National Provider Directory

Locations

3461 Cottman Ave
Philadelphia, PA 19149
Phone (215) 624-6007

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1265682082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "address_2": "SUITE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194284108",
            "telephone_number": "610-567-5513",
            "fax_number": "610-567-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3461 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491605",
            "telephone_number": "215-624-6007",
            "fax_number": "215-624-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZARETH PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "WAJDA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "215-335-6043"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.