Provider First Line Business Practice Location Address: 
ALBERT EINSTEIN MEDICAL CENTER
    Provider Second Line Business Practice Location Address: 
5501 OLD YORK ROAD
    Provider Business Practice Location Address City Name: 
PHILADELPHIA
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
19141
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
215-456-8520
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
06/26/2019