Organization
LAND MEDICAL CORPORATION
Active
Other names
MedNet Healthcare Systems
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY I BALOGUN PH.D (CHAIRMAN/CEO)
(215) 294-6790
Entity
Organization
Contact information
Practice address
4 NESHAMINY INTERPLEX DR STE 101, FEASTERVILLE TREVOSE, PA 19053-6940
(215) 294-6790
(215) 474-4418
Mailing address
4 NESHAMINY INTERPLEX DR STE 101, FEASTERVILLE TREVOSE, PA 19053-6940
(215) 294-6790
(215) 474-4418
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018467050006
—
PA
Enumeration date
03/13/2014
Last updated
02/10/2025
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