| NPI | 1881445807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KARANIUK Credentialing Director 484-494-2465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-12-09 |