Organization
GAUDENZIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG WARREN MA, MBA (REGIONAL DIRECTOR)
(410) 367-5551
Entity
Organization
Contact information
Practice address
106 W MAIN ST, NORRISTOWN, PA 19401-4716
(610) 239-9600
Mailing address
570 RITCHIE HWY, SUITE H, SEVERNA PARK, MD 21146-2925
(410) 975-0067
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366656175
COMMERCIAL
MD
05
—
417123300
—
MD
Enumeration date
10/14/2015
Last updated
10/14/2015
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