Individual
DR. JUDD HARRIS FASTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 CHESTNUT ST FL 6, PHILADELPHIA, PA 19107
(215) 955-6760
(215) 923-4532
Mailing address
925 CHESTNUT ST FL 6, PHILADELPHIA, PA 19107-4204
(215) 955-6760
(215) 923-4532
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD463975
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2013
Last updated
06/21/2018
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