Provider Demographics
NPI:1699786426
Name:MARGUERITE R BILLBROUGH PC
Entity type:Organization
Organization Name:MARGUERITE R BILLBROUGH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:BILLBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-522-2822
Mailing Address - Street 1:1553 CHESTER PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CRUM LYNNE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1005
Mailing Address - Country:US
Mailing Address - Phone:610-522-2822
Mailing Address - Fax:610-522-2880
Practice Address - Street 1:1098 W BALTIMORE PIKE STE 3301
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-522-2822
Practice Address - Fax:610-522-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK8125OtherRAILROAD MEDICARE
1313017OtherBLUE SHIELD
CK8125OtherRAILROAD MEDICARE