Organization
MAIN LINE GASTROENTEROLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE SUDER (BILLING MANAGER)
(215) 723-2333
Entity
Organization
Contact information
Practice address
255 W LANCASTER AVE, PAOLI MEDICAL BUILDING, SUITE 332, PAOLI, PA 19301-1763
(610) 644-6755
(610) 647-2063
Mailing address
255 W LANCASTER AVE, PAOLI MEDICAL BUILDING, SUITE 332, PAOLI, PA 19301-1763
(610) 644-6755
(610) 647-2063
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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