Organization
CITY LINE E.N.T., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE P MAUER D.O. (OWNER)
(215) 879-0060
Entity
Organization
Contact information
Practice address
4190 CITY AVE, STE 526, PHILADELPHIA, PA 19131-1626
(215) 879-0060
(215) 879-0063
Mailing address
4190 CITY AVE, STE 526, PHILADELPHIA, PA 19131-1626
(215) 879-0060
(215) 879-0063
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
OS0011941L
PA
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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