Provider Demographics
NPI:1407253388
Name:NUNGESSER, EDWIN ALOYISUS III (ATC)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:ALOYISUS
Last Name:NUNGESSER
Suffix:III
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BROWNSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1830
Mailing Address - Country:US
Mailing Address - Phone:267-467-3091
Mailing Address - Fax:
Practice Address - Street 1:12 BROWNSTONE DR
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-1830
Practice Address - Country:US
Practice Address - Phone:267-467-3091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer