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Organization

EXCELSIA PA, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CONSTANTINE MISOUL (MEDICAL DIRECTOR)
(410) 933-5678
Entity
Organization

Contact information

Practice address
901 W ASHLAND AVE, GLENOLDEN, PA 19036-1101
(610) 461-6450
Mailing address
9601 PULASKI PARK DR STE 417, MIDDLE RIVER, MD 21220-1409

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
11/14/2022
Last updated
11/14/2022
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