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General NPI Number Information
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NPI Number | 1972201549
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Entity Type | Organization
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Legal Business Name | AT HOME CARDIOLOGY PC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 2 BALA PLZ # 20
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1501
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Country | US
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Telephone | 610-660-0800
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Fax | 610-660-0360
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Provider Business Mailing Address
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Address Line | PO BOX 14
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City | BALA CYNWYD
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State | PA
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Zip | 19004-0014
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Country | US
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Telephone | 610-660-0800
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Fax | 610-660-0360
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Authorized Official
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Title or Position | AO
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Name | JUSTIN PERRY
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Credential |
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Telephone | 445-201-2800
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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 |
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License Number State |
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