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General NPI Number Information
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NPI Number | 1285761031
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Entity Type | Organization
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Legal Business Name | EASTER SEALS OF SOUTHEASTERN PENNSYLVANIA
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 12/13/2018
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Provider Practice Location Address
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Address Line | 3975 CONSHOHOCKEN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-5426
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Country | US
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Telephone | 215-879-1000
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Fax | 215-879-8424
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Provider Business Mailing Address
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Address Line | 3975 CONSHOHOCKEN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-5426
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Country | US
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Telephone | 215-879-1000
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Fax | 215-879-8424
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE CFO
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Name | MS. IVY C LEWIS
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Credential |
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Telephone | 215-879-3542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225CA2400X
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Taxonomy Name | Assistive Technology Practitioner Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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