Organization
DELAWARE VALLEY I.D. ASSOCIATES, P.C.
Active
Organization
DELAWARE VALLEY I.D. ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CAVALLARO (DIRECTOR OF FINANCE AND OPERATIONS)
(610) 896-0210
Entity
Organization
Contact information
Practice address
100 E LANCASTER AVE, MOB EAST 556, WYNNEWOOD, PA 19096-3450
(610) 896-0210
(610) 896-5101
Mailing address
100 E LANCASTER AVE, MOB EAST 556, WYNNEWOOD, PA 19096-3450
(610) 896-0210
(610) 896-5101
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0061398000
KEYSTONE HEALTH PLAN EAST
PA
05
—
01886952
—
PA
01
—
097746
INDEPENDENCE BLUE CROSS
PA
01
—
54910
AETNA
PA
Enumeration date
07/27/2006
Last updated
01/22/2020
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