| NPI | 1730371683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FORTINO Owner 215-336-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: PA OS009599L) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |