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Organization
LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP
Active
Organization
LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR PAUL MIRIANA (CEO)
16097036905
Entity
Organization
Contact information
Practice address
1341 N DELAWARE AVE, SUITE 307, PHILADELPHIA, PA 19125-4300
(215) 922-9334
(215) 420-1777
Mailing address
1341 N DELAWARE AVE, SUITE 307, PHILADELPHIA, PA 19125-4300
(215) 922-9334
(215) 420-1777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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