| NPI | 1306262456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY I BALOGUN Chairman/CEO 215-294-6790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA 136220) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 136220) |
| 208D00000X General Practice (Licence: PA 136220) | |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-03-13 |