Provider Demographics
NPI:1366786055
Name:HEALTH ACCESS NETWORK
Entity type:Organization
Organization Name:HEALTH ACCESS NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-497-7407
Mailing Address - Street 1:PO BOX 8500-6355
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:610-497-7520
Mailing Address - Fax:610-497-7525
Practice Address - Street 1:1 BARTOL AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2214
Practice Address - Country:US
Practice Address - Phone:610-521-0150
Practice Address - Fax:610-521-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty