Provider Demographics
NPI:1255361523
Name:NEPHROLOGY MEDICAL ASSOCIATES, LTD
Entity type:Organization
Organization Name:NEPHROLOGY MEDICAL ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FASS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:610-534-6235
Mailing Address - Street 1:1501 LANSDOWNE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1333
Mailing Address - Country:US
Mailing Address - Phone:610-534-6235
Mailing Address - Fax:610-534-6166
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:610-534-6235
Practice Address - Fax:610-534-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty