| NPI | 1427002112 |
|---|---|
| Doing Business As | GLENSIDE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JOHN J KELLY Chief Of Staff 215-481-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-11-02 |