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Specialty details in registry · Wyomissing, PA

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At a glance

2201 Ridgewood Rd Ste 160, Wyomissing, PA 19610-1190

NPPES record updated Mar 17, 2018. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

2201 Ridgewood Rd Ste 160
Wyomissing, PA 19610-1190

Additional reported practice locations

1413 W Moyamensing Ave Fl 1
Philadelphia, PA 191454625
Phone: 4845715454
Fax: 6108980609
2200 Hamilton St Ste 212
Allentown, PA 181046329
Phone: 4845715454
Fax: 6108980609
Professional details: NPI, taxonomy & registry record
NPI1063937381
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
246Z00000X
Enumeration date
Aug 8, 2017
Record updated
Mar 17, 2018
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

246Z00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

2201 Ridgewood Rd Ste 160
Wyomissing, PA 19610-1190
Phone
(484) 571-5454
Fax
(610) 898-0609
Mailing address
2208 QUARRY DR STE 203

WEST LAWN, PA 196091158
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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