Provider Demographics
NPI: | 1831139187 |
---|---|
Name: | HEALTH ACCESS NETWORK |
Entity type: | Organization |
Organization Name: | HEALTH ACCESS NETWORK |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MEDICAL DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VICTOR |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HERESNIAK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 610-447-6254 |
Mailing Address - Street 1: | PO BOX 13973 |
Mailing Address - Street 2: | HAN EMERGENCY PHYSICIANS |
Mailing Address - City: | PHILADELPHIA |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19101 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-666-2455 |
Mailing Address - Fax: | 610-617-6280 |
Practice Address - Street 1: | 1 MEDICAL CENTER BLVD |
Practice Address - Street 2: | CROZER CHESTER MEDICAL CENTER |
Practice Address - City: | UPLAND |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19013 |
Practice Address - Country: | US |
Practice Address - Phone: | 215-447-2000 |
Practice Address - Fax: | 610-617-6280 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-06-07 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty |