Provider Demographics
NPI:1366185548
Name:EMBRACE PENNSLYVANIA LLC
Entity type:Organization
Organization Name:EMBRACE PENNSLYVANIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-341-0901
Mailing Address - Street 1:22 FOSSEN WAY
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-6300
Mailing Address - Country:US
Mailing Address - Phone:978-621-9870
Mailing Address - Fax:
Practice Address - Street 1:22 FOSSEN WAY
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-6300
Practice Address - Country:US
Practice Address - Phone:978-621-9870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREFREE PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty