Healthcare Provider Details

I. General information

NPI: 1972777803
Provider Name (Legal Business Name): BENJAMIN NOH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 DEKALB PIKE
NORRISTOWN PA
19401-1820
US

IV. Provider business mailing address

12 GILL ST
WOBURN MA
01801-1728
US

V. Phone/Fax

Practice location:
  • Phone: 610-278-2000
  • Fax:
Mailing address:
  • Phone: 781-937-4545
  • Fax: 781-937-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD433641
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: