Organization
LA SALLE ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE EMIG (EXECUTIVE DIRECTOR)
(215) 687-6286
Entity
Organization
Contact information
Practice address
1434 N 2ND ST, PHILADELPHIA, PA 19122-3802
(215) 739-5804
Mailing address
970 SPROUL RD, BRYN MAWR, PA 19010-2026
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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