| NPI | 1619359536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SREEKANTH AMBATI President 215-350-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D78913) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2015-06-27 |