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1800 Lombard Street 5th Floor Philadelphia PA 19146-8400 | |
| (215) 893-2541 | |
| (215) 893-2542 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1800 Lombard Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Wanda Cronrath (DIRECTOR PHYSICIAN GROJUP) |
| Authorized Official Contact | 6107768344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
850 S 5th Street Allentown PA 18103-3295 Ph: (610) 776-8344 | 1800 Lombard Street 5th Floor Philadelphia PA 19146-8400 Ph: (215) 893-2541 |
| NPI Number | 1780977587 |
|---|---|
| Provider Enumeration Date | 05/26/2011 |
| Last Update Date | 05/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780977587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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