Healthcare Provider Details

I. General information

NPI: 1598216533
Provider Name (Legal Business Name): BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 OLD LANCASTER RD STE 420
BRYN MAWR PA
19010-3236
US

IV. Provider business mailing address

825 OLD LANCASTER RD STE 320
BRYN MAWR PA
19010-3235
US

V. Phone/Fax

Practice location:
  • Phone: 610-527-4896
  • Fax:
Mailing address:
  • Phone: 610-527-3800
  • Fax: 610-527-0608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOE DESILVA
Title or Position: CEO
Credential:
Phone: 610-527-3800