Philadelphia Freedom Valley Young Men'S Christian Association

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

PHILADELPHIA FREEDOM VALLEY YOUNG MEN'S CHRISTIAN ASSOCIATION

Practice address

891 N Eagle Rd
Havertown, PA 19083-2127

Phone

(610) 649-0700

NPI assigned

Sep 6, 2016

Organization subpart

No

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

Authorized official

Name

Shaun Elliott

Title

Ceo/President

Phone

(215) 963-3704

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1720535909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FAYETTE ST",
            "address_2": "SUITE 250",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194281904",
            "telephone_number": "267-592-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 N EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832127",
            "telephone_number": "610-649-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA FREEDOM VALLEY YOUNG MEN'S CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "215-963-3704"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Educator in Havertown, PA
• Providers in Havertown, PA by specialty
• Health Educator in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.