Provider Demographics
NPI:1730269713
Name:MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE
Entity type:Organization
Organization Name:MADLYN AND LEONARD ABRAMSON CENTER FOR JEWISH LIFE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-371-1854
Mailing Address - Street 1:261 OLD YORK RD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3706
Mailing Address - Country:US
Mailing Address - Phone:215-371-3490
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD
Practice Address - Street 2:SUITE 318
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3706
Practice Address - Country:US
Practice Address - Phone:215-371-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA771205251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA394211OtherBLUE CROSS PROVIDER #
PAFI718169OtherBLUE SHIELD PROVIDER # SU
PA1007600910067Medicaid
PA394211OtherBLUE CROSS PROVIDER #