Organization
CARDIOVASCULAR ASSOCIATES OF SOUTHEASTER PENNSYLVANIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MABRY (EXECUTIVE DIRECTOR)
(610) 649-7625
Entity
Organization
Contact information
Practice address
100 E LANCASTER AVE, STE 356EAST, WYNNEWOOD, PA 19096-3450
(610) 649-7625
(610) 649-3362
Mailing address
100 E LANCASTER AVE, STE 356EAST, WYNNEWOOD, PA 19096-3450
(610) 649-7625
(610) 649-3362
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007334230015
—
PA
Enumeration date
06/23/2005
Last updated
02/08/2010
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