| NPI | 1336537448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine |
| 207VX0201X Obstetrics & Gynecology Gynecologic Oncology | |
| 261QA0005X Clinic/Center Ambulatory Family Planning Facility | |
| 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology | |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2020-11-19 |