Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD433662 | PA |
NPI | 1144436403 |
---|---|
Provider Name | Dr. Kevin Jay Cross |
First Address | Villanova, PA 19085-2035 |
Second Address | Wayne, PA 19087-2523 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 11/07/2011 |