Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Jul 25, 2010
License(s)
C1-0011181 (DE), MT196756 (PA), MD452964 (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5501 OLD YORK RD STE 3006 | Philadelphia, PA 19141-3018 | 215-456-7979 |
| MAILING | 101 E OLNEY AVE STE 400 | Philadelphia, PA 19120-2470 | 215-456-1825 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.