NPI 1740307099

Uscg Sector Delaware Bay

Organisation Military Health Care Provider Philadelphia, PA

Practice location

Address: 1 Washington Ave, Philadelphia, PA 19147-4335
Phone: (215) 271-4816
Fax: (215) 271-4817

Authorised official

Name: Jivonne Nikell Prioleau-Green
Title: Health Service Technician
Phone: (215) 271-4816

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X

Other Military Health Care Provider providers in Pennsylvania →

Registry record

NPI: 1740307099
Entity type: Organization
NPI issued: 23 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.