| NPI | 1437363512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES STEVEN BLAKE CEO/Medical Director 215-849-4902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2011-06-03 |