Basic Information
| Provider Information | |||||||||
| NPI: | 1669845020 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | EIFE | ||||||||
| FirstName: | BROOKE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 331 VILLAGE WAY | ||||||||
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| City: | CHALFONT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189141846 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 146 MARPLE RD | ||||||||
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| City: | BROOMALL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190082040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103560100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2015 | ||||||||
| LastUpdateDate: | 11/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC014246 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.