| NPI | 1710937362 |
|---|---|
| Former Legal Business Name | DR.CAVINESS |
| Entity Type | Organization |
| Authorized Contact | PAUL HENRY CAVINESS Doctor 215-741-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PA os007697) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-08-22 |