Provider Demographics
NPI:1942505730
Name:PENN THERAPEUTIC INC
Entity Type:Organization
Organization Name:PENN THERAPEUTIC INC
Other - Org Name:NONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-287-3529
Mailing Address - Street 1:7764 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2612
Mailing Address - Country:US
Mailing Address - Phone:267-287-3529
Mailing Address - Fax:
Practice Address - Street 1:7764 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2612
Practice Address - Country:US
Practice Address - Phone:267-287-3529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000140225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty