| NPI | 1457049439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET FERRARIE Sr. Manager Payer Credentialing 215-707-2433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-12-19 |