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
—
—
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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