Organization
KEYSTONE MOBILE PARTNERS, LP
Active
Other names
Keystone Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A DERNOGA (EXEC. DIRECTOR)
(215) 675-9900
Entity
Organization
Contact information
Practice address
2701 BLAIR MILL RD, STE. 30, WILLOW GROVE, PA 19090-1041
(215) 675-9900
(215) 675-4096
Mailing address
2701 BLAIR MILL RD, STE. 30, WILLOW GROVE, PA 19090-1041
(215) 675-9900
(215) 675-4096
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
15331501
PA
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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