Provider Demographics
NPI:1306187166
Name:PRESIDENTIAL MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:PRESIDENTIAL MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COACHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-276-8788
Mailing Address - Street 1:1 BALA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 BALA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3212
Practice Address - Country:US
Practice Address - Phone:215-276-8788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066378L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty