| NPI | 1295011419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN FUSETTI Assoc. VP, Health Plan Services 215-955-9298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2026-01-15 |