Organization
PENNSYLVANIA VASCULAR ASSOCIATES, P.C.
Active
Other names
PA Vascular Assoc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRIDGET ANNE WALSH (PRACTICE MANAGER)
(215) 829-5093
Entity
Organization
Contact information
Practice address
700 SPRUCE STREET, STE 101, PHILADELPHIA, PA 19106-0423
(215) 829-5000
(215) 627-0578
Mailing address
700 SPRUCE STREET, STE 101, PHILADELPHIA, PA 19106-0423
(215) 829-5000
(215) 627-0578
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016875000001
—
PA
01
—
CN5867
RAILROAD MEDICARE
PA
Enumeration date
12/15/2006
Last updated
01/10/2013
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