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7900 Old York Rd 115 A Elkins Park PA 19027-2318 | |
| (215) 635-0808 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 7900 Old York Rd, Elkins Park, Pennsylvania |
| Authorized Official Name and Position | Mathew Cherian (PRESIDENT) |
| Authorized Official Contact | 2156631223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7900 Old York Rd 115 A Elkins Park PA 19027-2318 Ph: (215) 635-0808 | 7900 Old York Rd 115 A Elkins Park PA 19027-2318 Ph: (215) 635-0808 |
| NPI Number | 1689915316 |
|---|---|
| Provider Enumeration Date | 03/05/2013 |
| Last Update Date | 08/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689915316 | NPI | - | NPPES |
| 1022041470033 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | DS037551 (Pennsylvania) | Primary |
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