| NPI | 1396822870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEANA COVELLO President 215-574-9101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: PA MD067435L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD067435L) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-05-11 |