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Organization
PENNSYLVANIA NEPHROLOGY ASSOCIATES, P.C.
Active
Organization
PENNSYLVANIA NEPHROLOGY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KWANBENA A NTOSO M.D. (PRESIDENT)
(215) 829-8420
Entity
Organization
Contact information
Practice address
230 W WASHINGTON SQ, SUITE 100, PHILADELPHIA, PA 19106-3500
(215) 829-8420
(215) 829-8418
Mailing address
230 W WASHINGTON SQ, SUITE 100, PHILADELPHIA, PA 19106-3500
(215) 829-8420
(215) 829-8418
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007648310006
—
PA
01
—
795759
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/10/2006
Last updated
04/20/2008
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