Organization
GEPS PHYSICIAN GROUP OF PENNSYLVANIA PC
Active
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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