Provider Demographics
NPI:1295056562
Name:INNOVATIVE HYPERBARIC SOLUTIONS OF NEWTOWN SQUARE
Entity type:Organization
Organization Name:INNOVATIVE HYPERBARIC SOLUTIONS OF NEWTOWN SQUARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-355-1747
Mailing Address - Street 1:3744 W CHESTER PIKE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3224
Mailing Address - Country:US
Mailing Address - Phone:610-355-1747
Mailing Address - Fax:610-355-1749
Practice Address - Street 1:3744 W CHESTER PIKE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3224
Practice Address - Country:US
Practice Address - Phone:610-355-1747
Practice Address - Fax:610-355-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009816L2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty