Healthcare Provider Details

I. General information

NPI: 1730983842
Provider Name (Legal Business Name): EAST END CLINICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PECAN STREET SE
WASHINGTON DC
20032-2652
US

IV. Provider business mailing address

367 S GULPH RD
KING OF PRUSSIA PA
19406-3121
US

V. Phone/Fax

Practice location:
  • Phone: 610-382-4422
  • Fax:
Mailing address:
  • Phone: 610-382-4422
  • Fax: 610-878-3965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TODD EVANS
Title or Position: VP
Credential:
Phone: 610-382-4422