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General NPI Number Information
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NPI Number | 1770506750
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Entity Type | Organization
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Legal Business Name | MERCY MANAGEMENT OF SEPA
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 5346 CEDAR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1918
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Country | US
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Telephone | 215-747-6661
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Fax | 215-471-1418
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Provider Business Mailing Address
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Address Line | 5346 CEDAR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1918
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Country | US
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Telephone | 215-747-6661
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Fax | 215-471-1418
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Authorized Official
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Title or Position | VICE PRESIDENT/CFO
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Name | DONALD E HALBERSTADT
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Credential |
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Telephone | 215-748-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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