Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
Advanced Wound Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CARUSO (PRESIDENT)
(215) 710-2651
Entity
Organization
Contact information
Practice address
1500 LANSDOWNE AVE, DARBY, PA 19023-1200
(610) 237-4000
Mailing address
41 UNIVERSITY DR STE 106, NEWTOWN, PA 18940-1873
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778793
—
PA
Enumeration date
03/26/2021
Last updated
04/19/2021
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