Organization
BRIGHTSIDE MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALPHONSO JOSIAH NATHAN (CO-OWNER)
(267) 902-9319
Entity
Organization
Contact information
Practice address
701 CROSS RD, LEDERACH, PA 19450-1945
(267) 902-9319
Mailing address
PO BOX 255, LEDERACH, PA 19450-0255
(267) 902-9319
(215) 256-1112
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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