Provider Demographics
NPI:1154932523
Name:MHP CONSHOHOCKEN LLC
Entity type:Organization
Organization Name:MHP CONSHOHOCKEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-935-6772
Mailing Address - Street 1:2401 W CHELTENHAM AVE STE 132
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 E RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2117
Practice Address - Country:US
Practice Address - Phone:215-935-6772
Practice Address - Fax:215-935-6389
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERION HEALTH PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care