Healthcare Provider Details

I. General information

NPI: 1235136276
Provider Name (Legal Business Name): JEFFREY A NACHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MEDICAL CENTER BLVD SUITE 305
UPLAND PA
19013-3955
US

IV. Provider business mailing address

30 MEDICAL CENTER BLVD SUITE 305
UPLAND PA
19013-3955
US

V. Phone/Fax

Practice location:
  • Phone: 610-874-6448
  • Fax: 610-876-7399
Mailing address:
  • Phone: 610-874-6448
  • Fax: 610-876-7399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number042215E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA05614300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: