| NPI | 1558759571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 207U00000X Nuclear Medicine |
| 2085N0700X Radiology, Neuroradiology | |
| 2085N0904X Radiology, Nuclear Radiology | |
| 2085P0229X Radiology, Pediatric Radiology | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2020-11-19 |