| NPI | 1659488351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-11-19 |