Organization
EASTER GAU LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EASTER GAU MS (PRESIDENT)
(215) 882-1442
Entity
Organization
Contact information
Practice address
309 S 43RD ST, PHILADELPHIA, PA 19104-4017
(267) 516-6600
Mailing address
1202 STOTESBURY AVE, WYNDMOOR, PA 19038-7440
(215) 882-1442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PC007932
PA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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