Skin And Laser Surgery Center Of Pen in Philadelphia - Specialist
Skin And Laser Surgery Center Of Pen - NPI 1871791954
Skin And Laser Surgery Center Of Pen is a Specialist in Philadelphia, Pennsylvania. Skin And Laser Surgery Center Of Pen practices all healthcare services and medical treatments related to Specialist. The NPI Number for Skin And Laser Surgery Center Of Pen is 1871791954. The last update date is 2016-04-14.
Skin And Laser Surgery Center Of Pen's current location address is 1528 Walnut St, Philadelphia, Pennsylvania. You can contact this provider via phone number 2157354994 and fax number 2157358376. The mailing address for Skin And Laser Surgery Center Of Pen is 1528 Walnut St, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Skin And Laser Surgery Center Of Pen |
|---|---|
| Address | 1528 Walnut St, Philadelphia, Pennsylvania |
| Phone Number | 2157354994 |
| Fax Number | 2157358376 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Greenbaum Samuel Steven |
| Credentials | M.D. |
| Telephone Number | 2157354994 |
NPI Number Detail
| NPI Number | 1871791954 |
|---|---|
| Provider Enumeration Date | 2007-07-10 |
| Last Updated Date | 2016-04-14 |
Provider Mailing Address Detail
| Address | 1528 Walnut St |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191023604 |
| Phone Number | 2157354994 |
| Fax Number | 2157358376 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | MD041412E |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 113285501 | PA | -- | |
| 170232 | PA | HIGHMARK BLUE SHIELD |
Post Comment/ Review Below
What is the Skin And Laser Surgery Center Of Pen's unique identification number?
The Skin And Laser Surgery Center Of Pen has been assigned the NPI (National Provider Identifier) Number 1871791954 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Skin And Laser Surgery Center Of Pen's facilities are geographically located?
The facilities of Skin And Laser Surgery Center Of Pen are physically situated at the following location: 1528 Walnut St, Philadelphia, PA, 191023604.
What is Skin And Laser Surgery Center Of Pen's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Skin And Laser Surgery Center Of Pen is Specialist, and the taxonomy code that categorizes this field of expertise is 174400000X.
On what date did the Skin And Laser Surgery Center Of Pen receive the assignment of its 1871791954 from the Centers for Medicare & Medicaid Services?
The Skin And Laser Surgery Center Of Pen was issued its 1871791954 by the Centers for Medicare & Medicaid Services on 2007-07-10.
As of what date were the Skin And Laser Surgery Center Of Pen's details last updated?
The information pertaining to the Skin And Laser Surgery Center Of Pen, including its address, specialty, and other details, was most recently updated on 2016-04-14.