Organization
ROXBOROUGH MEDICAL NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE FENSTERMACHER (CREDENTIALING MANAGER)
(570) 366-4606
Entity
Organization
Contact information
Practice address
5735 RIDGE AVE, SUITE 106, PHILADELPHIA, PA 19128-1745
(570) 366-4606
(570) 366-5032
Mailing address
5735 RIDGE AVE, SUITE 106, PHILADELPHIA, PA 19128-1745
(570) 366-4606
(570) 366-5032
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
01/19/2015
Last updated
03/10/2015
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