Organization
MERCY PEDIATRIC ASSOCIATES PC
Active
Other names
Lansdowne Park Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE GENOVA MD (PRESIDENT)
(610) 237-4995
Entity
Organization
Contact information
Practice address
1503 LANSDOWNE AVE, STE 3002, DARBY, PA 19023
(610) 237-4995
(610) 237-7311
Mailing address
1503 LANSDOWNE AVE, STE 3002, DARBY, PA 19023
(610) 237-4995
(610) 237-7311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014441550002
—
PA
01
—
0018123
USHC
—
01
—
0297647
CIGNA
—
01
—
0464621001
IBC
—
01
—
634564
BS
—
Enumeration date
02/21/2006
Last updated
07/03/2011
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