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General NPI Number Information
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NPI Number | 1659593457
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC ENDOCRINE ASSOCIATES
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 834 CHESTNUT ST SUITE M 207
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5127
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Country | US
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Telephone | 215-922-2442
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Fax | 215-923-1108
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Provider Business Mailing Address
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Address Line | 834 CHESTNUT ST SUITE M 207
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5127
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Country | US
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Telephone | 215-922-2442
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Fax | 215-923-1108
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORRAINE C KING
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Credential | MD
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Telephone | 215-922-2442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 054916
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License Number State | PA
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