| Mcl Primary Care, Llc. | |
|
882 Jacksonville Rd Suite 204 Ivyland PA 18974-4836 | |
| (215) 957-1100 | |
| (215) 957-1111 |
| Full Name | Mcl Primary Care, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 882 Jacksonville Rd, Ivyland, Pennsylvania |
| Authorized Official Name and Position | Michael C. Luciano (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2159571100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcl Primary Care, Llc. 882 Jacksonville Rd Suite 204 Ivyland PA 18974-4836 Ph: (215) 957-1100 | Mcl Primary Care, Llc. 882 Jacksonville Rd Suite 204 Ivyland PA 18974-4836 Ph: (215) 957-1100 |
| NPI Number | 1114251816 |
|---|---|
| Provider Enumeration Date | 09/28/2009 |
| Last Update Date | 11/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114251816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS014106 (Pennsylvania) | Primary |