Provider Demographics
NPI:1275573503
Name:PLUMSTEADVILLE FAMILY PRACTICE
Entity Type:Organization
Organization Name:PLUMSTEADVILLE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-766-8844
Mailing Address - Street 1:5612 EASTON RD
Mailing Address - Street 2:P O BOX 866
Mailing Address - City:PLUMSTEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18949
Mailing Address - Country:US
Mailing Address - Phone:215-766-8844
Mailing Address - Fax:215-766-0733
Practice Address - Street 1:5612 EASTON RD
Practice Address - Street 2:
Practice Address - City:PLUMSTEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:18949
Practice Address - Country:US
Practice Address - Phone:215-766-8844
Practice Address - Fax:215-766-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty