Provider Demographics
NPI:1467469544
Name:EAST SHORE PSYCHIATRIC ASSOCIATES PC
Entity Type:Organization
Organization Name:EAST SHORE PSYCHIATRIC ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-540-4420
Mailing Address - Street 1:2209 FOREST HILLS DR
Mailing Address - Street 2:STE 19
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112
Mailing Address - Country:US
Mailing Address - Phone:717-540-4420
Mailing Address - Fax:717-540-4427
Practice Address - Street 1:4601 DEVONSHIRE RD STE 100
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1547
Practice Address - Country:US
Practice Address - Phone:717-540-4420
Practice Address - Fax:717-540-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAEA922302OtherBS
PA02305500OtherBC
PAEA922302OtherBS