Organization
GEPS PHYSICIAN GROUP OF PENNSYLVANIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHAPIRO (VICE PRESIDENT)
(410) 832-7790
Entity
Organization
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348
(610) 925-4157
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(410) 494-7607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018752700014
—
PA
01
—
GE1338676
HIGHMARK BS GREOUP #
PA
Enumeration date
07/19/2006
Last updated
08/05/2019
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