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General NPI Number Information
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NPI Number | 1457472235
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Entity Type | Organization
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Legal Business Name | EASTERN PA DOWN SYNDROME CENTER
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6900 HAMILTON BLVD.,
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City | TREXLERTOWN
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State | PA
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Zip | 18087-0060
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Country | US
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Telephone | 610-402-0184
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Fax | 610-402-0132
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Provider Business Mailing Address
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Address Line | PO BOX 60 6900 HAMILTON BLVD.,
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City | TREXLERTOWN
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State | PA
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Zip | 18087-0060
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Country | US
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Telephone | 610-402-0184
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Fax | 610-402-0132
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM BRYAN MELTZER
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Credential | BS ENGINEERING
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Telephone | 610-395-8586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 029527E
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License Number State | PA
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