Provider Demographics
NPI:1922279488
Name:A&E PEDORTHIC FACILITY
Entity Type:Organization
Organization Name:A&E PEDORTHIC FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZOLTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-736-2227
Mailing Address - Street 1:914 TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-1412
Mailing Address - Country:US
Mailing Address - Phone:215-736-2227
Mailing Address - Fax:
Practice Address - Street 1:914 TRENTON RD
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-1412
Practice Address - Country:US
Practice Address - Phone:215-736-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1251730001Medicare NSC