Facts
- Status
- A
- Type
- Individual
- Enumeration date
- 2017-08-24
- Last updated
- 2017-08-24
Specialties
Licenses
- License PA
- RP451726
Location
- Practice location
- 2319 YORK RD
- City
- JAMISON PA
- Postal code
- 189291037
- Phone
- 215-343-1488
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.