Organization
VAGABONDING THROUGH THE ETHER
Active
Other names
Vagabonding Through The Ether
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL GRODOFSKY MD (OWNER)
(267) 225-4759
Entity
Organization
Contact information
Practice address
1300 HORIZON DR STE 101, CHALFONT, PA 18914-3970
(267) 225-4759
Mailing address
1300 HORIZON DR STE 101, CHALFONT, PA 18914-3970
(267) 225-4759
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD451221
PA
208VP0014X
Interventional Pain Medicine Physician
Primary
MD451221
PA
Other
Enumeration date
12/21/2016
Last updated
01/13/2017
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