Individual
DRISANA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-3537
(215) 590-3537
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD460390
PA
2080A0000X
Pediatric Adolescent Medicine Physician
MT212704
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2014
Last updated
10/15/2018
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