Provider Demographics
NPI:1285933895
Name:TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Entity type:Organization
Organization Name:TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSYLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-710-2175
Mailing Address - Street 1:1201 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1201
Mailing Address - Country:US
Mailing Address - Phone:215-710-2000
Mailing Address - Fax:
Practice Address - Street 1:1201 LANGHORNE NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1201
Practice Address - Country:US
Practice Address - Phone:215-710-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty