PAOLI OB/GYN ASSOCIATES, P.C. (NPI# 1174570220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174570220 |
| Entity Type | Organization |
| Organization Name | PAOLI OB/GYN ASSOCIATES, P.C. |
| Practice Address |
100 E Lancaster Ave Ste 660 Lankenau Medical Building East Wynnewood PA 19096-3450 |
| Practice Telephone | 6108967550 |
| Practice Fax Number | 6108967914 |
| Mailing Telephone | 6108967550 |
| Mailing Fax Number | 6108967914 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2010-12-01 |
| Authorized Official Name | DR. JOSEPH L RUSSINO (PRESIDENT) |
| Authorized Official Telephone | 6108967550 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD | 51756 | 01 |
| PA | INDEPENDENCE BLUE CROSS | 0661441000 | 01 |
| PA | AETNA | 504367 | 01 |
| Street Address |
100 E LANCASTER AVE STE 660 LANKENAU MEDICAL BUILDING EAST |
| City | WYNNEWOOD |
| State | PA |
| Zip Code | 19096-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619925674 | Jennifer K. Stuck | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 660, Lankenau Medical Building East, Wynnewood, PA 19096-3450 | 2006-05-04 |
| 1083636831 | Jennifer C. Gilbert | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 660, Lankenau Medical Building East, Wynnewood, PA 19096-3450 | 2006-07-24 |
| 1558301218 | Mark Edward Chasteney | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 660, Lankenau Medical Building East, Wynnewood, PA 19096-3450 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831727866 | Jeffrey Glenn Johnston | Hospitalist | Lankenau Medical Center. 100 E Lancaster Ave, Wynnewood, PA 19096 | 2020-03-27 |
| 1326500331 | Maitri Pancholy | Student in an Organized Health Care Education/Training Program | Annenberg Center, G-10, 100 Lancaster Avenue, Wynnewood, PA 19096 | 2019-04-01 |
| 1306355987 | Karie Elizabeth Melton | Social Worker | 250 E Wynnewood Rd E12, Wynnewood, PA 19096 | 2017-09-26 |
| 1518320662 | Kaitlyn Kennard | Surgery | 100 Lancaster Ave Mob South Suite 422, Wynnewood, PA 19096 | 2016-04-05 |
| 1366814675 | Linda Elkins | Counselor | 543 Haverford Rd, Wynnewood, PA 19096 | 2015-10-26 |
| 1619347655 | Tessa Kovick | Registered Nurse | 100 E Lancaster Ave Ste 114, Wynnewood, PA 19096 | 2015-10-02 |
| 1922476415 | Amy Lenrow | Skilled Nursing Facility | 1510 Powder Mill Lane, Wynnewood, PA 19096 | 2015-09-14 |
| 1144602855 | Casey Dajao | Internal Medicine | 100 E Lancaster Ave Ste 140, Wynnewood, PA 19096 | 2015-06-18 |
| 1649666223 | Benjamin Larson | Internal Medicine | 100 E Lancaster Ave Ste B11, Wynnewood, PA 19096 | 2015-04-10 |
| 1760873285 | Kathleen Gilmartin | Nurse Practitioner | 100 East Lancaster Ave, Wynnewood, PA 19096 | 2015-02-06 |
| Find all providers in zip 19096 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265822779 | Howard Isaacson | Obstetrics & Gynecology | 217 Wiltshire Rd, Wynnewood, PA 19096-3332 | 2015-02-04 |
| 1326300187 | Crystal Aja Brogan | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 561, Wynnewood, PA 19096-3436 | 2012-06-07 |
| 1528229770 | Licette Almonte | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 216, Wynnewood, PA 19096-3448 | 2008-06-20 |
| 1447458302 | Jodi Slepian | Obstetrics & Gynecology | 404 Mayflower Ln, Wynnewood, PA 19096-1663 | 2007-07-03 |
| 1598837767 | Edward Lawrence Langan IIi | Obstetrics & Gynecology | Lankenau Med East, Suite 551, Wynnewood, PA 19096 | 2006-11-14 |
| 1043248271 | Gregory C. Bolton Sr. | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 135, Wynnewood, PA 19096-3453 | 2006-06-28 |
| 1134169386 | Shelia Parvin Kambin | Obstetrics & Gynecology | 100 Lancaster Ave, Suite 661 Lankenau Mob East, Wynnewood, PA 19096-3437 | 2006-06-07 |
| 1619925674 | Jennifer K. Stuck | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 660, Lankenau Medical Building East, Wynnewood, PA 19096-3450 | 2006-05-04 |
| 1679198188 | Joseph Elias Abdul-malak | Obstetrics & Gynecology | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-06-10 |
| 1154946747 | Samuel Philip Mellits | Obstetrics & Gynecology | 100 E Lancaster Ave Ste 301, Wynnewood, PA 19096-3446 | 2020-06-10 |
| Find all providers in WYNNEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.