MEDICARE: BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	17101501	PA

General Provider Information

NPI Number	:	1205963568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION

Provider Business Mailing Address
First Line	:	825 OLD LANCASTER RD
Second Line	:	SUITE 320
City	:	BRYN MAWR
State	:	PA
Zip	:	19010-3200
Country	:	US
Telephone Number	:	610-527-3800
Fax Number	:	610-527-0334

Provider Business Practice Location Address
First Line	:	825 OLD LANCASTER RD STE 330
Second Line	:
City	:	BRYN MAWR
State	:	PA
Zip	:	19010-3235
Country	:	US
Telephone Number	:	610-527-3800
Fax Number	:	610-527-0334

Authorized Official
Title or Position	:	CEO
Name	:	JOE DESILVA
Credential	:
Telephone Number	:	610-527-3800

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	03/26/2024

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