Organization · Type 2 NPI

Broad Street Professional Medical Services LLC

Vascular Surgery Physician · Philadelphia, PA

NPI number 1720630650 Active

Practice location

2033 S Broad St Ste A
Philadelphia, PA 19148-5505

Call (215) 795-3855 Map

Fax (224) 235-4652

Mailing address

PO Box 302
Northbrook, IL 60065-0302

Specialties and licenses

TaxonomyCodeLicense
Vascular Surgery Physician Primary 2086S0129XNone listed

Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

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About NPI 1720630650

Broad Street Professional Medical Services LLC's National Provider Identifier is 1720630650, issued on Jul 11, 2019. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 11, 2019.