Healthcare Provider Details

I. General information

NPI: 1093826547
Provider Name (Legal Business Name): BRYN MAWR NEPHROLOGY ASSOC. LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/20/2021
Certification Date: 03/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 OLD LANCASTER RD SUITE 206
BRYN MAWR PA
19010
US

IV. Provider business mailing address

830 OLD LANCASTER RD SUITE 206
BRYN MAWR PA
19010
US

V. Phone/Fax

Practice location:
  • Phone: 610-525-8110
  • Fax: 484-380-3525
Mailing address:
  • Phone: 610-525-8110
  • Fax: 484-380-3525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY R. ZAPPACOSTA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-825-8110