| Lee G Dante Mdpa | |
|
321 Berkeley Rd Merion Station PA 19066-1403 | |
| (610) 667-5488 | |
| (610) 667-8117 |
| Full Name | Lee G Dante Mdpa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 321 Berkeley Rd, Merion Station, Pennsylvania |
| Authorized Official Name and Position | Lee Gerard Dante (PRESIDENT) |
| Authorized Official Contact | 6106675448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee G Dante Mdpa 321 Berkeley Rd Merion Station PA 19066-1403 Ph: (610) 667-5488 | Lee G Dante Mdpa 321 Berkeley Rd Merion Station PA 19066-1403 Ph: (610) 667-5488 |
| NPI Number | 1851504880 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 08/13/2009 |
| Medicare PECOS PAC ID | 0840238960 |
|---|---|
| Medicare Enrollment ID | O20050420000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851504880 | NPI | - | NPPES |
| 525681000 | Medicaid | MD | |
| 998300 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD014206E (Pennsylvania) | Primary |
| Provider Name | Lee G. Dante |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649483678 PECOS PAC ID: 2668566795 Enrollment ID: I20071105000041 |
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