Laurie E Etzrodt | |
301 Oxford Valley Rd 304a Yardley PA 19067-7706 | |
(215) 493-8896 | |
(215) 340-1867 |
Full Name | Laurie E Etzrodt |
---|---|
Speciality | Social Worker |
Location | 301 Oxford Valley Rd, Yardley, Pennsylvania |
Authorized Official Name and Position | Laurie E Etzrodt (PRESIDENT) |
Authorized Official Contact | 2154938896 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Laurie E Etzrodt 301 Oxford Valley Rd 304a Yardley PA 19067-7706 Ph: (215) 493-8896 | Laurie E Etzrodt 301 Oxford Valley Rd 304a Yardley PA 19067-7706 Ph: (215) 493-8896 |
NPI Number | 1740669019 |
---|---|
Provider Enumeration Date | 05/20/2015 |
Last Update Date | 05/20/2015 |
Medicare PECOS PAC ID | 5092036111 |
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Medicare Enrollment ID | O20150602000250 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740669019 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CWO14488 (Pennsylvania) | Primary |
Provider Name | Laurie E Etzrodt |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1093868408 PECOS PAC ID: 1355662479 Enrollment ID: I20150602000312 |
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