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General NPI Number Information
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NPI Number | 1154635365
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Entity Type | Organization
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Legal Business Name | SAINTS THEODORE AND FRANCES PREVENTIVE MEDICINE
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 605 FLORAL VALE BLVD
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City | YARDLEY
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State | PA
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Zip | 19067-5528
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Country | US
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Telephone | 215-968-1020
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Fax | 215-968-1051
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Provider Business Mailing Address
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Address Line | 605 FLORAL VALE BLVD
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City | YARDLEY
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State | PA
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Zip | 19067-5528
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Country | US
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Telephone | 215-968-1020
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Fax | 215-968-1051
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. PHILIP GAYLORD LEWIS
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Credential |
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Telephone | 215-968-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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