Healthcare Provider Details

I. General information

NPI: 1366631822
Provider Name (Legal Business Name): WEST CHESTER GI ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 W LINCOLN HWY
EXTON PA
19341-2547
US

IV. Provider business mailing address

915 OLD FERN HILL RD BLDG B
WEST CHESTER PA
19380-4269
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-3122
  • Fax: 610-431-4799
Mailing address:
  • Phone: 610-431-3122
  • Fax: 610-431-4799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0016630620003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: LAURENCE M WEINBERG
Title or Position: PHYSICIAN
Credential: MD
Phone: 610-431-3122