| NPI | 1881631737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE TRENT Manager Practice 215-677-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PA MD016271E) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2011-10-06 |