Healthcare Provider Details

I. General information

NPI: 1659065993
Provider Name (Legal Business Name): PHMC DELCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LANDSDOWNE AVE
DARBY PA
19023
US

IV. Provider business mailing address

1600 LANDSDOWNE AVE
DARBY PA
19023
US

V. Phone/Fax

Practice location:
  • Phone: 215-370-8529
  • Fax:
Mailing address:
  • Phone: 215-370-8529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. RAJAN VISWANATHAN
Title or Position: SENIOR DIRECTOR OF QUALITY
Credential: MBA
Phone: 215-370-8529