Mcl Primary Care, Llc. | |
882 Jacksonville Rd Suite 204 Ivyland PA 18974-4836 | |
(215) 957-1100 | |
(215) 957-1111 |
Full Name | Mcl Primary Care, Llc. |
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Speciality | Family Medicine |
Location | 882 Jacksonville Rd, Ivyland, Pennsylvania |
Authorized Official Name and Position | Michael C. Luciano (PHYSICIAN/OWNER) |
Authorized Official Contact | 2159571100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mcl Primary Care, Llc. 882 Jacksonville Rd Suite 204 Ivyland PA 18974-4836 Ph: (215) 957-1100 | Mcl Primary Care, Llc. 882 Jacksonville Rd Suite 204 Ivyland PA 18974-4836 Ph: (215) 957-1100 |
NPI Number | 1114251816 |
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Provider Enumeration Date | 09/28/2009 |
Last Update Date | 11/16/2009 |
Identifier | Type | State | Issuer |
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1114251816 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OS014106 (Pennsylvania) | Primary |