Provider Demographics
NPI:1700987187
Name:NAZARETH HOSPITAL
Entity Type:Organization
Organization Name:NAZARETH HOSPITAL
Other - Org Name:THERAPLEX OF NAZARETH HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT REHAB
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GALUP
Authorized Official - Suffix:
Authorized Official - Credentials:MBA,MS,OTR/L
Authorized Official - Phone:215-335-3954
Mailing Address - Street 1:8131 ROOSEVELT BLVD.
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152
Mailing Address - Country:US
Mailing Address - Phone:215-335-3954
Mailing Address - Fax:215-335-4812
Practice Address - Street 1:8131 ROOSEVELT BLVD.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:215-335-3954
Practice Address - Fax:215-335-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008070283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital