Provider Demographics
NPI:1427561075
Name:DIABETES AND ENDOCRINOLOGY CONSULTANTS OF PENNSYLVANIA LLC
Entity type:Organization
Organization Name:DIABETES AND ENDOCRINOLOGY CONSULTANTS OF PENNSYLVANIA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAVALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-953-6804
Mailing Address - Street 1:1234 BRIDGETOWN PIKE STE 310
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-2208
Mailing Address - Country:US
Mailing Address - Phone:215-953-6804
Mailing Address - Fax:215-953-6804
Practice Address - Street 1:1234 BRIDGETOWN PIKE STE 310
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-2208
Practice Address - Country:US
Practice Address - Phone:215-953-6804
Practice Address - Fax:215-953-6804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052765L207RE0101X
PAOS005007L207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty