| NPI | 1043618390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN COSENZA Credentialing Specialist 215-830-9991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2023-08-23 |