SKIN AND LASER SURGERY CENTER OF PEN (NPI# 1871791954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871791954 |
| Entity Type | Organization |
| Organization Name | SKIN AND LASER SURGERY CENTER OF PEN |
| Other Organization Name | STEVEN S. GREENBAUM, MD |
| Practice Address |
1528 Walnut St Stuite 1101 Philadelphia PA 19102-3604 |
| Practice Telephone | 2157354994 |
| Practice Fax Number | 2157358376 |
| Mailing Telephone | 2157354994 |
| Mailing Fax Number | 2157358376 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2016-04-14 |
| Authorized Official Name | DR. STEVEN SAMUEL GREENBAUM (PRESIDENT) |
| Authorized Official Telephone | 2157354994 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD041412E | PA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD | 170232 | 01 |
| PA | 113285501 | 05 |
| Other Name | Type Code |
|---|---|
| STEVEN S. GREENBAUM, MD | Other Name - Individual/Organization |
| Street Address |
1528 WALNUT ST STUITE 1101 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19102-3604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427605013 | Bridget Catherine Littley | Counselor | 1528 Walnut St, Philadelphia, PA 19102-3604 | 2019-08-20 |
| 1639603715 | Rachel Kabasakalian-mckay | Psychologist | 1528 Walnut St, Suite 302, Philadelphia, PA 19102-3604 | 2017-04-17 |
| 1720448186 | Kristen Jones | Physician Assistant | 1528 Walnut St, Suite 950, Philadelphia, PA 19102-3604 | 2016-02-29 |
| 1073922621 | Norma Kisaiti | Counselor | 1528 Walnut St, Philadelphia, PA 19102-3604 | 2014-08-07 |
| 1104128818 | Carole S Levin | Optometrist | 1528 Walnut St, Pearle Vision, Philadelphia, PA 19102-3604 | 2010-12-01 |
| 1134432909 | Dr. Myron B. Goldberg, D.d.s. | Dentist | 1528 Walnut St, Suite 1725, Philadelphia, PA 19102-3604 | 2010-07-21 |
| 1215160957 | Gino C Curcuruto | Chiropractor | 1528 Walnut St, Philadelphia, PA 19102 | 2009-08-28 |
| 1518192004 | Steven Matthew Stoll | Emergency Medicine | 1528 Walnut St, Suite 950, Philadelphia, PA 19102-3604 | 2009-05-27 |
| 1528207776 | Lucinda Mitchell | Counselor | 1528 Walnut St, Suite1706, Philadelphia, PA 19102-3604 | 2009-02-11 |
| 1639330087 | Autism Living and Working, Inc. | Case Management | 1528 Walnut St, Suite 815, Philadelphia, PA 19102-3604 | 2008-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650847 | Alexandre Mason Sharma | Student in an Organized Health Care Education/Training Program | 200 N 16th St Apt 1318, Philadelphia, PA 19102 | 2019-06-29 |
| 1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
| 1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
| 1245898170 | Parth Javia | Internal Medicine | 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-05 |
| 1588120968 | John Granger II | Social Worker | 1500 Market St. 12th Floor Suite 75, Philadelphia, PA 19102 | 2019-02-11 |
| 1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
| 1770076465 | Sarthi Dalal | Internal Medicine | 245 N 15th St, Fl 6, Ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1255824033 | Joyce Nimo-boampong | Internal Medicine | Drexel University College of Medicine, 245 N 15th St, 6th Floor,ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1134625692 | Emma Rose Gormley | Social Worker | 1601 Walnut St Ste 1516, Philadelphia, PA 19102 | 2018-04-03 |
| 1851808497 | Sunish Shah | Pharmacist | 230 N Broad St, Philadelphia, Pa 19102, Philadelphia, PA 19102 | 2018-01-04 |
| Find all providers in zip 19102 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174156012 | Sade Yolanda Davis | Specialist | 2414 N Garnet St, Philadelphia, PA 19132-3725 | 2020-02-19 |
| 1356803993 | Larkerra Goodson | Specialist | 1336 Arrott St Apt E15, Philadelphia, PA 19124-3281 | 2019-04-03 |
| 1306302617 | Keisha Robinson | Specialist | 6852 Regent St, Philadelphia, PA 19142-1213 | 2019-02-12 |
| 1740758168 | William Whitaker | Specialist | 1115 E Sanger St, Philadelphia, PA 19124-1130 | 2018-11-02 |
| 1902395536 | Ran Barzilay | Specialist | 3440 Market St, Suite 200, Philadelphia, PA 19104 | 2018-05-09 |
| 1093229668 | Danielle M Marshall | Specialist | 514 Seville St Apt 7, Philadelphia, PA 19128-2737 | 2017-11-19 |
| 1336651017 | Radhia Afif | Specialist | 5943 Weymouth St, Philadelphia, PA 19120-1122 | 2017-11-02 |
| 1306383401 | Helping Hair LLC | Specialist | 930 N 50th St, Philadelphia, PA 19131-5102 | 2017-01-26 |
| 1447796172 | Kristen Halvorson | Specialist | 3411 Cresson St, Apartment 6, Philadelphia, PA 19129-1654 | 2017-01-19 |
| 1174079131 | Sadia Randolph | Specialist | 6718 Paschall Ave, Philadelphia, PA 19142-1809 | 2016-08-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19102 |
Please comment or provide details below to improve the information on SKIN AND LASER SURGERY CENTER OF PEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.