Provider Demographics
NPI:1255002507
Name:DAVID GVINIANIDZE ARTS AND MUSIC CENTER INC
Entity Type:Organization
Organization Name:DAVID GVINIANIDZE ARTS AND MUSIC CENTER INC
Other - Org Name:DAVID GVINIANIDZE ARTS AND MUSIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GVINIANIDZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-200-9044
Mailing Address - Street 1:1575 W STREET RD APT 636
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3162
Mailing Address - Country:US
Mailing Address - Phone:718-200-9044
Mailing Address - Fax:
Practice Address - Street 1:716 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1307
Practice Address - Country:US
Practice Address - Phone:718-200-9044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care