Provider Demographics
NPI:1265544456
Name:DRESHER FAMILY MEDICINE, P.C.
Entity type:Organization
Organization Name:DRESHER FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY LOU
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEWCUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-628-3350
Mailing Address - Street 1:830 TWINING RD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025
Mailing Address - Country:US
Mailing Address - Phone:215-628-3350
Mailing Address - Fax:215-628-4137
Practice Address - Street 1:830 TWINING ROAD
Practice Address - Street 2:SUITE 6
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025
Practice Address - Country:US
Practice Address - Phone:215-628-3350
Practice Address - Fax:215-628-4137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
033874401OtherKEYSTONE
383784OtherBCBS
383784OtherBCBS