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General NPI Number Information
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NPI Number | 1861494056
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Entity Type | Organization
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Legal Business Name | EASTON CARDIOVASCULAR ASSOCIATES, PC
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 175 S 21ST ST
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City | EASTON
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State | PA
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Zip | 18042-3835
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Country | US
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Telephone | 610-442-2082
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 FAIRVIEW AVE
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City | EASTON
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State | PA
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Zip | 18042-3915
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Country | US
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Telephone | 610-258-4337
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Fax | 610-258-8502
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | DEBRA DEANGELES
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Credential |
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Telephone | 610-973-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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