Provider Demographics
NPI:1922649011
Name:ZABRECKY INSTITUTE OF BIOMEDICINE
Entity Type:Organization
Organization Name:ZABRECKY INSTITUTE OF BIOMEDICINE
Other - Org Name:ZABRECKY INSTITUTE OF BIOMEDIC
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COUGHLAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:610-616-2510
Mailing Address - Street 1:789 E LANCASTER AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1527
Mailing Address - Country:US
Mailing Address - Phone:610-616-2500
Mailing Address - Fax:610-616-2525
Practice Address - Street 1:789 E LANCASTER AVE STE 230
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1527
Practice Address - Country:US
Practice Address - Phone:610-616-2500
Practice Address - Fax:610-616-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty