Basic Information
| Provider Information | |||||||||
| NPI: | 1144250127 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARIATRIC SPECIALISTS OF PENNSYLVANIA, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 YPSILANTI | ||||||||
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| City: | YPSILANTI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345471174 | ||||||||
| FaxNumber: | 7345471161 | ||||||||
| Practice Location | |||||||||
| Address1: | 280 MIDDLETOWN BLVD | ||||||||
| Address2: | |||||||||
| City: | LANGHORNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2675723100 | ||||||||
| FaxNumber: | 2675723161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 11/03/2016 | ||||||||
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| AuthorizedOfficialLastName: | LEDESMA | ||||||||
| AuthorizedOfficialFirstName: | ELIHU | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT FOREST HEALTH SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 7345471410 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.