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Pearl Lake — NPI 1053907261, Philadelphia, PA | NPI Central

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Pearl Lake

NPI 1053907261 · Military Health Care Provider · Philadelphia, PA

Provider details

NPI number: 1053907261
Entity type: Individual
Primary specialty: Military Health Care ProviderOther Service Providers
Sex: Female
Sole proprietor: Yes
License: 70000634RMA (PA)

Practice location

2214 S 57th St

Philadelphia, PA 19143-5705

Phone: (886) 884-8807

Fax: (215) 825-5161

More PA providers

Mailing address

2250 E Monmouth St

Philadelphia, PA 19134-4103

Registry dates

Enumerated: 2020-12-12
Last updated: 2020-12-12

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.