| NPI | 1447260435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204F00000X Transplant Surgery |
| 207N00000X Dermatology | |
| 207R00000X Internal Medicine | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine Gastroenterology | |
| 207RN0300X Internal Medicine Nephrology | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207RS0012X Internal Medicine Sleep Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 208600000X Surgery | |
| 2086S0129X Surgery Vascular Surgery | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-11-19 |