Graduated: 2000
NPI: 1184773129
Practice Locations (2)
CITY OF PHILADELPHIA
131 E CHELTEN AVE, HEALTH CARE CTR 9
PHILADELPHIA, PA 191442153
2156855747
CITY OF PHILADELPHIA
4400 HAVERFORD AVE
PHILADELPHIA, PA 191041361
2156857630
Source: CMS National Downloadable File, September 2026.