| NPI | 1629201314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ANTHONY CHAVARRIA Physician 215-745-7970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA MD044909E) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2010-10-14 |