Organization
DISTAR INC.
Active
Organization
DISTAR INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA VULFIN (MANAGER)
(215) 464-7573
Entity
Organization
Contact information
Practice address
10890 BUSTLETON AVE, SUITE 204, PHILADELPHIA, PA 19116-3313
(215) 464-7573
(215) 464-7573
Mailing address
10890 BUSTLETON AVE, SUITE 204, PHILADELPHIA, PA 19116-3313
(215) 464-7573
(215) 464-7573
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
07/16/2006
Last updated
06/17/2010
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