Organization
CARDIOLOGY CONSULTANTS OF PHILADELPHIA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA L MUTCH (CREDENTIALING COORDINATOR)
(267) 479-4142
Entity
Organization
Contact information
Practice address
1703 S BROAD ST STE 300, PHILADELPHIA, PA 19148-1536
(215) 463-5333
(215) 463-8085
Mailing address
207 N BROAD ST FL 3, PHILA, PA 19107-1500
(267) 479-4142
(215) 463-3820
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010768630036
—
PA
Enumeration date
08/12/2005
Last updated
09/02/2020
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