| Corelife Valley, Llc | |
|
3601 Chichester Ave Unit 101 Upper Chichester PA 19061-3149 | |
| (484) 768-6762 | |
| (855) 772-4748 |
| Full Name | Corelife Valley, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3601 Chichester Ave Unit 101, Upper Chichester, Pennsylvania |
| Authorized Official Name and Position | Raymond Joseph Kostkowski (CEO) |
| Authorized Official Contact | 4109910044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corelife Valley, Llc 1111 Benfield Blvd Ste 250 Millersville MD 21108-3005 Ph: (800) 905-3261 | Corelife Valley, Llc 3601 Chichester Ave Unit 101 Upper Chichester PA 19061-3149 Ph: (484) 768-6762 |
| NPI Number | 1326681214 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 10/25/2021 |
| Certification Date | 10/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326681214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |