Provider Demographics
NPI:1679117592
Name:GAUDENZIA INC
Entity type:Organization
Organization Name:GAUDENZIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF CORPORATE FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHABAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:610-239-9600
Mailing Address - Street 1:106 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4716
Mailing Address - Country:US
Mailing Address - Phone:610-239-9600
Mailing Address - Fax:610-275-7025
Practice Address - Street 1:617 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:PA
Practice Address - Zip Code:17314-9199
Practice Address - Country:US
Practice Address - Phone:717-990-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251K00000XAgenciesPublic Health or Welfare