Organization
IBS CENTERS FOR ADVANCED FOOD ALLERGY TESTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL STIERSTORFER M.D. (PRESIDENT)
(215) 557-7430
Entity
Organization
Contact information
Practice address
1601 WALNUT ST, SUITE 501, PHILADELPHIA, PA 19102-2944
(215) 557-7430
(215) 661-0302
Mailing address
1601 WALNUT ST, SUITE 501, PHILADELPHIA, PA 19102-2944
(215) 557-7430
(215) 661-0302
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD042406E
PA
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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