| NPI | 1710855358 |
|---|---|
| Doing Business As | PRIMARY CARE SERVICES AT AZALEA TRACE |
| Entity Type | Organization |
| Authorized Contact | SUSAN AHERN SVP, CFO 215-661-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |