Provider Demographics
NPI:1457472235
Name:EASTERN PA DOWN SYNDROME CENTER
Entity Type:Organization
Organization Name:EASTERN PA DOWN SYNDROME CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:MELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:BS ENGINEERING
Authorized Official - Phone:610-395-8586
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:6900 HAMILTON BLVD.,
Mailing Address - City:TREXLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18087-0060
Mailing Address - Country:US
Mailing Address - Phone:610-402-0184
Mailing Address - Fax:610-402-0132
Practice Address - Street 1:6900 HAMILTON BLVD.,
Practice Address - Street 2:
Practice Address - City:TREXLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18087-0060
Practice Address - Country:US
Practice Address - Phone:610-402-0184
Practice Address - Fax:610-402-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA029527E261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF40436Medicare UPIN
PAB36333Medicare UPIN