Organization
DELAWARE VALLEY I.D. ASSOCIATES, P.C.
Active
Parent organization
DELAWARE VALLEY I.D. ASSOCIATES, P.C.
Other names
MIC PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELAWARE VALLEY I.D. ASSOCIATES, P.C.
Authorized official
LAWRENCE L LIVORNESE MD (MANAGING PARTNER)
(610) 896-0210
Entity
Organization
Contact information
Practice address
100 E LANCASTER AVE, MOB EAST 556, WYNNEWOOD, PA 19096
(610) 896-0210
Mailing address
901 MCCLINTOCK DR STE 202, BURR RIDGE, IL 60527-0872
(630) 655-7290
(630) 655-7290
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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