| NPI | 1649766742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LINCOW Owner 215-338-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2021-09-15 |