Provider Demographics
NPI:1003804626
Name:FORT WASHINGTON RADIOLOGICAL ASSOCIATES PC
Entity type:Organization
Organization Name:FORT WASHINGTON RADIOLOGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SEELAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-542-1247
Mailing Address - Street 1:2501 OREGON PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4890
Mailing Address - Country:US
Mailing Address - Phone:717-293-3223
Mailing Address - Fax:717-390-2455
Practice Address - Street 1:1244 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-1743
Practice Address - Country:US
Practice Address - Phone:215-542-1247
Practice Address - Fax:215-542-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA156196Medicare PIN
PACA1151Medicare PIN