| Organization Name: | PROSPECT HEALTH ACCESS NETWORK, INC. |
| NPI Number: | 1013364538 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLEN SHIN (SECRETARY) |
| Mailing Address: | 1 Medical Center Blvd Pob Ii Suite 220 Chester |
| State: | PA US |
| Postal Code: | 190133902 |
| Phone Number: | 6106198420 |
| Fax Number: | 6106198421 |
| NPI Enumeration Date: | 05/16/2016 |
| NPI Last Update Date: | 05/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Transplant Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |