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General NPI Number Information
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NPI Number | 1710447016
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Entity Type | Organization
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Legal Business Name | NAZARETH PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 1403 RHAWN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2803
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Country | US
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Telephone | 215-728-6688
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Fax |
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Provider Business Mailing Address
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Address Line | 41 UNIVERSITY DR STE 300
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City | NEWTOWN
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State | PA
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Zip | 18940-1873
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, MEDICAL GROUP
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Name | AMIT POWAR
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Credential |
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Telephone | 215-710-6573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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