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1720630650
BROAD STREET PROFESSIONAL MEDICAL SERVICES LLC
PHILADELPHIA, PA
NPI
1720630650
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Entity Type
Organization
Authorized Contact
AMI ALMEDA
Credentialing Manager
224-318-0118
Organization Subpart ?
No
Primary Taxonomy
2086S0129X Surgery, Vascular Surgery
Enumeration Date
2019-07-11
Last Update Date
2019-07-11
Business Address
BROAD STREET PROFESSIONAL MEDICAL SERVICES LLC
2033 S BROAD ST STE A
PHILADELPHIA, PA 19148-5505
Phone number: 215-795-3855
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Mailing Address
BROAD STREET PROFESSIONAL MEDICAL SERVICES LLC
PO BOX 302
NORTHBROOK, IL 60065-0302
Phone number: 847-593-8460
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