| NPI | 1205678117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN PADGETT Credentialing Manager 215-955-1175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |