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Organization
MINUTECLINIC DIAGNOSTIC OF PENNSYLVANIA LLC
Active
Organization
MINUTECLINIC DIAGNOSTIC OF PENNSYLVANIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH PINCINCE (ADMINISTRATOR)
(401) 770-3813
Entity
Organization
Contact information
Practice address
1218 E LANCASTER AVE, BRYN MAWR, PA 19010-2616
(866) 389-2727
Mailing address
PO BOX 772, MINUTECLINIC CREDENTIALING-MC2295, WOONSOCKET, RI 02895-0784
(401) 770-3813
(401) 406-3539
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO3508
MEDICARE RAILROAD
PA
Enumeration date
02/19/2007
Last updated
04/30/2024
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