Graduated: 2008
NPI: 1417271131
Practice Locations (2)
CITY OF PHILADELPHIA
131 E CHELTEN AVE, HEALTH CARE CTR 9
PHILADELPHIA, PA 191442153
2156855747
CITY OF PHILADELPHIA
321 W GIRARD AVE, HEALTH CARE CTR 6
PHILADELPHIA, PA 191231531
2156853808
Source: CMS National Downloadable File, September 2026.