| NPI | 1225426349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 208200000X Plastic Surgery | |
| 208600000X Surgery | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2020-11-19 |