| Organization Name: | YOUR NEIGHBORHOOD DOC PC |
| NPI Number: | 1336335090 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMMANUEL FERMIN HIPOLITO (OWNER) |
| Mailing Address: | 38 Thompson Park Kane |
| State: | PA US |
| Postal Code: | 167350399 |
| Phone Number: | 8148379841 |
| Fax Number: | 8148376494 |
| NPI Enumeration Date: | 09/17/2007 |
| NPI Last Update Date: | 11/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD037007L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |