Organization
CENTER FOR DERMATOLOGY, LASER AND COSMETIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD FARBER M.D. (OWNER)
(215) 676-2464
Entity
Organization
Contact information
Practice address
9892 BUSTLETON AVE, SUITE 204, PHILADELPHIA, PA 19115-2184
(215) 676-2464
(215) 676-5536
Mailing address
822 MONTGOMERY AVE, SUITE 100, NARBERTH, PA 19072-1937
(610) 664-4433
(610) 664-5290
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD032429E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095922
MEDICARE PTAN
PA
05
—
101436700001
—
PA
01
—
2430802000
INDEPENDENCE BLUE CROSS
PA
01
—
CE1764878
BLUE SHIELD
PA
Enumeration date
02/06/2007
Last updated
02/11/2013
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