Individual
LARRY KAISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-8484
(215) 707-3946
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-8484
(215) 707-3946
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD044147L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012408990003
—
PA
Enumeration date
07/04/2006
Last updated
03/22/2018
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