Basic Information
| Provider Information | |||||||||
| NPI: | 1336742956 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WASHINGTON PHYSICIAN SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95 LEONARD AVE | ||||||||
| Address2: | BLDG 2 4TH FLOOR | ||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242233857 | ||||||||
| FaxNumber: | 7242292961 | ||||||||
| Practice Location | |||||||||
| Address1: | 140 WELLNESS WAY | ||||||||
| Address2: | SUITE 86 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242506001 | ||||||||
| FaxNumber: | 7242506004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2020 | ||||||||
| LastUpdateDate: | 11/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | LAZARUS | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | STUART | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7242291756 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.