# MAINLINE BODYBRAIN&SPINE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215346879
- **Authorized official:** DR. GINA MARIA BENAQUISTA DESIPIO D.O. (PRESIDENT)
- **Authorized official phone:** (215) 284-0509

## Contact information

- **Practice address:** 118 CONWAY AVE, NARBERTH, PA 19072-2202
- **Practice address phone:** (215) 284-0509
- **Mailing address:** 118 CONWAY AVE, NARBERTH, PA 19072-2202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | OS015314 | PA | Yes |
| 2081P0004X | Spinal Cord Injury Medicine Physician | OS015314 | PA | — |

## Other

- **Enumeration date:** 08/07/2014
- **Last updated:** 08/07/2014