Organization
VISTA MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY DURLOFSKY D.O. (PRESIDENT)
(302) 598-7667
Entity
Organization
Contact information
Practice address
160 ROCK HILL RD FL 1, BALA CYNWYD, PA 19004-2133
(610) 667-6080
(610) 668-1580
Mailing address
160 ROCK HILL RD FL 1, BALA CYNWYD, PA 19004-2133
(610) 667-6080
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001045604
—
DE
Enumeration date
10/18/2006
Last updated
07/11/2013
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