Healthcare Provider Details
I. General information
NPI: 1255399689
Provider Name (Legal Business Name): NORTH PENN ANESTHESIOLOGY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2006
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 MEDICAL CAMPUS DR
LANSDALE PA
19446-1259
US
IV. Provider business mailing address
205 NEWTOWN RD SUITE 208
WARMINSTER PA
18974-5207
US
V. Phone/Fax
- Phone: 215-773-9564
- Fax: 215-773-9602
- Phone: 215-773-9564
- Fax: 215-773-9602
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAY
M
MERGAMAN
Title or Position: CEO
Credential: M.D.
Phone: 215-773-9514