Bryn Mawr Primary Care Llc | |
735 Old Lancaster Rd Bryn Mawr PA 19010-3414 | |
(610) 520-1127 | |
(610) 520-1143 |
Full Name | Bryn Mawr Primary Care Llc |
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Speciality | Internal Medicine |
Location | 735 Old Lancaster Rd, Bryn Mawr, Pennsylvania |
Authorized Official Name and Position | Winifred A. Constable (OWNER) |
Authorized Official Contact | 6105201127 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bryn Mawr Primary Care Llc 735 Old Lancaster Rd Bryn Mawr PA 19010-3414 Ph: (610) 520-1127 | Bryn Mawr Primary Care Llc 735 Old Lancaster Rd Bryn Mawr PA 19010-3414 Ph: (610) 520-1127 |
NPI Number | 1336445592 |
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Provider Enumeration Date | 02/07/2011 |
Last Update Date | 11/28/2011 |
Medicare PECOS PAC ID | 9739364332 |
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Medicare Enrollment ID | O20110426000080 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336445592 | NPI | - | NPPES |
102639968-0001 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Pennsylvania) | Primary |
Provider Name | Winifred A Constable |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1770897282 PECOS PAC ID: 5193900793 Enrollment ID: I20110426000095 |
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