| Easter Gau Llc | |
|
309 S 43rd St Philadelphia PA 19104-4017 | |
| (267) 516-6600 | |
| Not Available |
| Full Name | Easter Gau Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 309 S 43rd St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Easter Gau (PRESIDENT) |
| Authorized Official Contact | 2158821442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Gau Llc 1202 Stotesbury Ave Wyndmoor PA 19038-7440 Ph: (215) 882-1442 | Easter Gau Llc 309 S 43rd St Philadelphia PA 19104-4017 Ph: (267) 516-6600 |
| NPI Number | 1013389477 |
|---|---|
| Provider Enumeration Date | 10/26/2015 |
| Last Update Date | 10/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013389477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PC007932 (Pennsylvania) | Primary |
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