Organization
JOSHUA BALOGUN MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ISRAEL BALOGUN PH.D. (CHAIRMAN/CEO)
(215) 704-8223
Entity
Organization
Contact information
Practice address
5044 SPRUCE STREET, PHILADELPHIA, PA 19139-4148
(215) 474-4410
Mailing address
5044 SPRUCE STREET, PHILADELPHIA, PA 19139-4148
(215) 474-4410
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
03/24/2008
Last updated
01/25/2011
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