Organization Name: | DELAWARE VALLEY MEDICAL MANAGEMENT |
NPI Number: | 1134127426 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DELORES DEBRUCE (BUSINESS OFFICE MANAGER) |
Mailing Address: | 100 Presidential Blvd 4th Floor Bala Cynwyd |
State: | PA US |
Postal Code: | 190041108 |
Phone Number: | 6106642122 |
Fax Number: | 6106642315 |
NPI Enumeration Date: | 07/11/2005 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 01161501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |