| Stephen M Gollomp Md Pc | |
|
Suite 161, Lankenau Medical Bldg East 100 East Lancaster Avenue Wynnewood PA 19096-3425 | |
| (610) 642-5371 | |
| (610) 642-5658 |
| Full Name | Stephen M Gollomp Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | Suite 161, Lankenau Medical Bldg East, Wynnewood, Pennsylvania |
| Authorized Official Name and Position | Stephen Michael Gollomp (PRESIDENT) |
| Authorized Official Contact | 6106425371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen M Gollomp Md Pc Suite 161, Lankenau Medical Bldg East 100 East Lancaster Avenue Wynnewood PA 19096-3425 Ph: (610) 642-5371 | Stephen M Gollomp Md Pc Suite 161, Lankenau Medical Bldg East 100 East Lancaster Avenue Wynnewood PA 19096-3425 Ph: (610) 642-5371 |
| NPI Number | 1841350758 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 02/25/2018 |
| Medicare PECOS PAC ID | 6103802376 |
|---|---|
| Medicare Enrollment ID | O20040628001018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841350758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MD024887E (Pennsylvania) | Primary |
| Provider Name | Stephen Michael Gollomp |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194723585 PECOS PAC ID: 7719001767 Enrollment ID: I20100909000126 |
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