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General NPI Number Information
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NPI Number | 1760823652
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Entity Type | Individual
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Provider Name | PAWEL CZESLAW MACHURA
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Gender | Male
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 2050 W CHESTER PIKE SUITE 115
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City | HAVERTOWN
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State | PA
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Zip | 19083-2742
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Country | US
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Telephone | 610-449-9669
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Fax | 610-449-5566
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Provider Business Mailing Address
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Address Line | 4816 WARRINGTON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19143-3414
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Country | US
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Telephone | 732-939-5517
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Fax | 610-449-5566
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 10745
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License Number State | PA
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