Provider Demographics
NPI:1639365950
Name:PAUL G. EPSTEIN, D.O., P.C.
Entity Type:Organization
Organization Name:PAUL G. EPSTEIN, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-494-4440
Mailing Address - Street 1:2602 W 9TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-2040
Mailing Address - Country:US
Mailing Address - Phone:610-494-4440
Mailing Address - Fax:610-859-0350
Practice Address - Street 1:2602 W 9TH ST STE 103
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:610-494-4440
Practice Address - Fax:610-859-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002695L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0031850001OtherIBC PERSONAL CHOICE
PA031757OtherHIGHMARK
PA0005950840002Medicaid
PA0031850001OtherAMERIHEALTH ADMINISTRATOR
PA0031850001OtherKEYSTONE HEALTH PLAN EAST
PAEP031757OtherMEDICARE
PA10185OtherKEYSTONE MERCY HEALTH
PA1256038002OtherCIGNA
PAD98464Medicare PIN