Provider Demographics
NPI:1518123710
Name:PARSELLS, PETER (PA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:PARSELLS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 W CHESTER PIKE
Mailing Address - Street 2:STE 245
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2304
Mailing Address - Country:US
Mailing Address - Phone:610-325-3880
Mailing Address - Fax:610-325-3887
Practice Address - Street 1:80 JAMES ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3938
Practice Address - Country:US
Practice Address - Phone:732-632-1571
Practice Address - Fax:732-632-1584
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055456363AM0700X
NJ25MP0019900363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical