Provider Demographics
NPI:1013320845
Name:ECHENBERG INSTITUTE FOR PELVIC AND SEXUAL PAIN
Entity Type:Organization
Organization Name:ECHENBERG INSTITUTE FOR PELVIC AND SEXUAL PAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:ECHENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-868-0104
Mailing Address - Street 1:623 W UNION BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3708
Mailing Address - Country:US
Mailing Address - Phone:610-868-0104
Mailing Address - Fax:610-868-0204
Practice Address - Street 1:430 W BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3784
Practice Address - Country:US
Practice Address - Phone:610-868-0104
Practice Address - Fax:610-868-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274043174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty