Provider Demographics
NPI:1982743951
Name:EASTER SEALS EASTERN PENNSYLVANIA
Entity Type:Organization
Organization Name:EASTER SEALS EASTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:F
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:610-289-0114
Mailing Address - Street 1:1501 LEHIGH ST
Mailing Address - Street 2:201
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3880
Mailing Address - Country:US
Mailing Address - Phone:610-289-0114
Mailing Address - Fax:610-289-4282
Practice Address - Street 1:1501 LEHIGH ST
Practice Address - Street 2:201
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3880
Practice Address - Country:US
Practice Address - Phone:610-289-0114
Practice Address - Fax:610-289-4282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000029930012Medicaid