| NPI | 1457023277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Payer Supervisor 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2021-09-30 |