Organization
EASTER SEALS OF SOUTHEASTERN PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVY C LEWIS (DIRECTOR OF FINANCE CFO)
(215) 879-3542
Entity
Organization
Contact information
Practice address
3975 CONSHOHOCKEN AVE, PHILADELPHIA, PA 19131-5426
(215) 879-1000
(215) 879-8424
Mailing address
3975 CONSHOHOCKEN AVE, PHILADELPHIA, PA 19131-5426
(215) 879-1000
(215) 879-8424
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000005500019
—
PA
Enumeration date
02/28/2007
Last updated
12/13/2018
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