Healthcare Provider Details

I. General information

NPI: 1932825841
Provider Name (Legal Business Name): MEREDITH PUENTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 SKIPPACK PIKE STE 300
BLUE BELL PA
19422-1749
US

IV. Provider business mailing address

725 SKIPPACK PIKE STE 300
BLUE BELL PA
19422-1749
US

V. Phone/Fax

Practice location:
  • Phone: 866-894-1300
  • Fax:
Mailing address:
  • Phone: 866-894-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA-3100696
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: