Organization
LAURIE TOLIN, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE SUDER (BILLING MANAGER)
(215) 723-2333
Entity
Organization
Contact information
Practice address
100 CHURCH RD, ARDMORE, PA 19003-2316
(610) 642-1806
(610) 645-5783
Mailing address
100 CHURCH RD, ARDMORE, PA 19003-2316
(610) 642-1806
(610) 645-5783
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD016388E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031830
AETNA
PA
Enumeration date
02/12/2007
Last updated
06/02/2008
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