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General NPI Number Information
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NPI Number | 1699774257
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Entity Type | Organization
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Legal Business Name | IMAGE GUIDED SURGERY ASSOCIATES, PC
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Dates
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Enumeration Date | 07/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5735 RIDGE AVE STE 106
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1745
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Country | US
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Telephone | 215-508-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 5735 RIDGE AVE STE 106
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1745
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Country | US
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Telephone | 215-508-5261
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Fax |
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Authorized Official
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Title or Position | CONVENTIONAL RADIOLOGIST
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Name | ROBERT WORTHINGTON-KIRSCH
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Credential | M.D.
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Telephone | 215-508-5261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State | PA
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