| NPI | 1518755222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET FERRARIE Sr. Manager Payer Credentialing 215-707-2433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| 2085R0001X Radiology Radiation Oncology | |
| 207RX0202X Internal Medicine Medical Oncology | |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-07-17 |