Provider Demographics
NPI:1285607630
Name:ENDOCRINE ASSOCIATES PC
Entity type:Organization
Organization Name:ENDOCRINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIHU
Authorized Official - Middle Name:N
Authorized Official - Last Name:GOREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:610-941-6799
Mailing Address - Street 1:633 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1002
Mailing Address - Country:US
Mailing Address - Phone:610-941-6799
Mailing Address - Fax:610-941-6381
Practice Address - Street 1:633 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1002
Practice Address - Country:US
Practice Address - Phone:610-941-6799
Practice Address - Fax:610-941-6381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5942146OtherAETNA
0048624000OtherIBC