| NPI | 1992948038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ANTHONY CHAVARRIA Manager 215-288-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA MD044909E) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-17 |