Organization
USCG SECTOR DELAWARE BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIVONNE NIKELL PRIOLEAU-GREEN (HEALTH SERVICE TECHNICIAN)
(215) 271-4816
Entity
Organization
Contact information
Practice address
1 WASHINGTON AVE, PHILADELPHIA, PA 19147-4335
(215) 271-4816
(215) 271-4817
Mailing address
1 WASHINGTON AVE, PHILADELPHIA, PA 19147-4335
(215) 271-4816
(215) 271-4817
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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