Organization
INTEGRATED WOUND CARE PENNSYLVANIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE LUSA MD (PRESIDENT)
(718) 705-6010
Entity
Organization
Contact information
Practice address
4400 W GIRARD AVE, PHILADELPHIA, PA 19104-1002
(718) 705-6010
Mailing address
492C CEDAR LN STE 514, TEANECK, NJ 07666-1713
(718) 705-6010
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/24/2018
Last updated
02/23/2022
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