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General NPI Number Information
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NPI Number | 1093826547
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Entity Type | Organization
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Legal Business Name | BRYN MAWR NEPHROLOGY ASSOC. LTD
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/20/2021
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Provider Practice Location Address
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Address Line | 830 OLD LANCASTER RD SUITE 206
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City | BRYN MAWR
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State | PA
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Zip | 19010
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Country | US
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Telephone | 610-525-8110
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Fax | 484-380-3525
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Provider Business Mailing Address
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Address Line | 830 OLD LANCASTER RD SUITE 206
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City | BRYN MAWR
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State | PA
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Zip | 19010
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Country | US
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Telephone | 610-525-8110
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Fax | 484-380-3525
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY R. ZAPPACOSTA
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Credential | M.D.
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Telephone | 610-825-8110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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