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Specialty details in registry · Ardmore, PA

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At a glance

40 E Montgomery Ave, Ardmore, PA 19003-2421

NPPES record updated Mar 4, 2024. Public records can lag behind changes at a practice.

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Practice location

40 E Montgomery Ave
Ardmore, PA 19003-2421
Professional details: NPI, taxonomy & registry record
NPI1629724828
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
253Z00000X
Enumeration date
Feb 25, 2022
Record updated
Mar 4, 2024
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

253Z00000X · Primary

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

Practice location

40 E Montgomery Ave
Ardmore, PA 19003-2421
Phone
(610) 719-3223
Mailing address
40 E MONTGOMERY AVE FL 4

ARDMORE, PA 190032421
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Information may be outdated or incomplete.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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