| NPI | 1508425992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DEFAZIO Executive Assistant 610-692-6280 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |