Provider Demographics
NPI:1750426839
Name:EUSEBIO R. NUNEZ MD PC
Entity type:Organization
Organization Name:EUSEBIO R. NUNEZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EUSEBIO
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-533-2407
Mailing Address - Street 1:1353 BRENTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3924
Mailing Address - Country:US
Mailing Address - Phone:215-533-2407
Mailing Address - Fax:215-533-2408
Practice Address - Street 1:1216 E HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-4928
Practice Address - Country:US
Practice Address - Phone:215-533-2407
Practice Address - Fax:215-533-2408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039335E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33587Medicare UPIN
PA410363Medicare ID - Type Unspecified