| NPI | 1366061574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD VINCENT PUCCIO President 610-668-6495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |