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General NPI Number Information
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NPI Number | 1679934475
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Entity Type | Organization
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Legal Business Name | MY MEDECIN LLC
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 01/22/2018
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Provider Practice Location Address
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Address Line | 250 W LANCASTER AVE SUITE 260
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City | PAOLI
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State | PA
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Zip | 19301
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Country | US
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Telephone | 319-573-7313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 535
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City | VILLANOVA
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State | PA
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Zip | 19085
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Country | US
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Telephone | 610-640-1333
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Fax | 877-872-0261
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Authorized Official
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Title or Position | MD
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Name | DR. DEEPTI THAPAR
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Credential | M.D.
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Telephone | 319-573-7313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | MD444916
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License Number State | PA
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