| NPI | 1962657346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN N. WIDERMAN Physician 215-934-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: PA OS004029L) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2008-11-26 |