Healthcare Provider Details

I. General information

NPI: 1275534638
Provider Name (Legal Business Name): ARELYNE PACHO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 CENTRAL AVE MARC J MEDWAY MD PC
PHILADELPHIA PA
19111-2442
US

IV. Provider business mailing address

PO BOX 602 MARC J MEDWAY MD PC
GWYNEDD VALLEY PA
19437-0602
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-3736
  • Fax: 215-728-3354
Mailing address:
  • Phone: 215-542-7260
  • Fax: 215-542-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD0391132
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: