# MERCY MANAGEMENT OF SEPA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SEPA Pain Management
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275059651
- **Authorized official:** AMIEE BRENNAN (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (610) 567-6964

## Contact information

- **Practice address:** 1501 LANSDOWNE AVE, DARBY, PA 19023-1333
- **Practice address phone:** (610) 555-1211
- **Mailing address:** 1 W ELM ST, CONSHOHOCKEN, PA 19428-4108
- **Mailing address phone:** (610) 567-6964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2017
- **Last updated:** 08/17/2017