| NPI | 1497767495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-11-19 |