| NPI | 1386872331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROSSELLO President 215-833-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: GA GA 002439) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: GA GA 002439) |
| 305R00000X Preferred Provider Organization (Licence: GA GA 002439) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2010-07-15 |