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Organization
MERCY MANAGEMENT OF SEPA
Active
Organization
MERCY MANAGEMENT OF SEPA
Active
Other names
SEPA Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
AMIEE BRENNAN (CREDENTIALING SUPERVISOR)
(610) 567-6964
Entity
Organization
Contact information
Practice address
1501 LANSDOWNE AVE, DARBY, PA 19023-1333
(610) 555-1211
Mailing address
1 W ELM ST, CONSHOHOCKEN, PA 19428-4108
(610) 567-6964
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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