| NPI | 1891875456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MARK MANDEL Practice Administrator 215-918-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2014-03-25 |