| NPI | 1013601541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY JONES Provider Enrollment Manager 215-456-8129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology | |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2023-06-13 |