| Abington Health Concussion | |
|
2510 Maryland Rd Suite 185 Willow Grove PA 19090-1109 | |
| (215) 481-4323 | |
| Not Available |
| Full Name | Abington Health Concussion |
|---|---|
| Speciality | Family Medicine |
| Location | 2510 Maryland Rd, Willow Grove, Pennsylvania |
| Authorized Official Name and Position | Michael B Walsh (SENIOR VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 2154812000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abington Health Concussion Po Box 826594 Philadelphia PA 19182-6594 Ph: (215) 481-4323 | Abington Health Concussion 2510 Maryland Rd Suite 185 Willow Grove PA 19090-1109 Ph: (215) 481-4323 |
| NPI Number | 1861742900 |
|---|---|
| Provider Enumeration Date | 09/17/2012 |
| Last Update Date | 10/12/2022 |
| Medicare PECOS PAC ID | 3274437736 |
|---|---|
| Medicare Enrollment ID | O20180420001807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861742900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 207T00000X | Neurological Surgery | (* (Not Available)) | Secondary |
| Provider Name | Douglas Walter Laske |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275521254 PECOS PAC ID: 0345146387 Enrollment ID: I20031210000585 |
| Provider Name | Michael J Graveley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558351668 PECOS PAC ID: 7810957263 Enrollment ID: I20041012000293 |
| Provider Name | Steven Barrer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194766386 PECOS PAC ID: 6204843741 Enrollment ID: I20100623000342 |
| Provider Name | Michael S Yoon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1821039090 PECOS PAC ID: 6507997731 Enrollment ID: I20100701000364 |
| Provider Name | Jonas J Gopez |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1083652051 PECOS PAC ID: 3577696541 Enrollment ID: I20100728000946 |
| Provider Name | Susan Fidler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184822504 PECOS PAC ID: 9032305586 Enrollment ID: I20101123000126 |
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