| |
3401 Market St Ste 105b Philadelphia PA 19104-3315 | |
(215) 220-4700 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 3401 Market St Ste 105b, Philadelphia, Pennsylvania |
Authorized Official Name and Position | Edward Waldov (DIRECTOR OF REVENUE CYCLE - FINANCE) |
Authorized Official Contact | 2152557751 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1601 Cherry St Ste 11511 Philadelphia PA 19102-1310 Ph: (215) 255-7751 | 3401 Market St Ste 105b Philadelphia PA 19104-3315 Ph: (215) 220-4700 |
NPI Number | 1356458772 |
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Provider Enumeration Date | 08/23/2006 |
Last Update Date | 06/09/2022 |
Identifier | Type | State | Issuer |
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1356458772 | NPI | - | NPPES |
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