| NPI | 1437425360 |
|---|---|
| Other Name | JUP ANCILLARY PROVIDERS |
| Entity Type | Organization |
| Authorized Contact | JOHN OGUNKEYE Executive Director 215-955-2562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 133N00000X Nutritionist |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2012-03-26 |