Healthcare Provider Details

I. General information

NPI: 1891134490
Provider Name (Legal Business Name): ANUPRIYA GROVER-WENK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 YORK RD SUITE 108
JENKINTOWN PA
19046-2852
US

IV. Provider business mailing address

1605 N CEDAR CREST BLVD STE 110B
ALLENTOWN PA
18104-2351
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-2725
  • Fax: 215-481-3013
Mailing address:
  • Phone: 610-973-1410
  • Fax: 610-973-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number273010
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19957
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT015161
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: