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General NPI Number Information
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NPI Number | 1205874666
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Entity Type | Organization
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Legal Business Name | CITY LINE CARDIOLOGY ASSOCIATES INC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 301 E CITY LINE AVE SUITE 240
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1708
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Country | US
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Telephone | 610-660-9895
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Fax | 610-660-9755
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Provider Business Mailing Address
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Address Line | 301 E CITY LINE AVE SUITE 240
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1708
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Country | US
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Telephone | 610-660-9895
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Fax | 610-660-9755
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Authorized Official
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Title or Position | OWNER
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Name | EVA PLACENTRA-SESSO
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Credential | D.O.
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Telephone | 610-660-9895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS005160L
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License Number State | PA
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