| NPI | 1396416251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Payer Supervisor 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0008X Internal Medicine, Hepatology |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| 208600000X Surgery | |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2021-09-23 |