| NPI | 1699744508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ONILE VAITKUS SESTOKAS Director 610-565-7726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD056902-L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 42740) |
| 207R00000X Internal Medicine (Licence: DE C1-0007370) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA07790400) | |
| 207R00000X Internal Medicine (Licence: NY 231589-1) | |
| 207R00000X Internal Medicine (Licence: OH 85370) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2009-06-03 |