Individual
CHANTEL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 S 9TH ST STE 600, PHILADELPHIA, PA 19107-6810
(215) 955-8430
Mailing address
1025 WALNUT ST STE 805, PHILADELPHIA, PA 19107-5001
(215) 955-8768
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD460654
PA
Other
Enumeration date
04/05/2012
Last updated
07/21/2022
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