Organization
CITY LINE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN GIBBONS (BILLER)
(215) 871-1800
Entity
Organization
Contact information
Practice address
4190 CITY AVE, SUITE 540, PHILADELPHIA, PA 19131-1626
(215) 871-1800
(215) 871-1807
Mailing address
4190 CITY AVE, SUITE 540, PHILADELPHIA, PA 19131-1626
(215) 871-1800
(215) 871-1807
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0S005355L
PA
Other
Enumeration date
07/11/2006
Last updated
09/04/2008
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