Provider Demographics
NPI:1639144397
Name:EDINGER, PATRICIA A (MED, ATC, EMT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:EDINGER
Suffix:
Gender:F
Credentials:MED, ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3646 VALLEY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4714
Mailing Address - Country:US
Mailing Address - Phone:267-934-5696
Mailing Address - Fax:
Practice Address - Street 1:1325 SUMNEYTOWN PIKE
Practice Address - Street 2:
Practice Address - City:GWYNEDD VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19437-0901
Practice Address - Country:US
Practice Address - Phone:215-646-7300
Practice Address - Fax:215-542-4683
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART002242A2255A2300X
NJ25MT001394002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer