Healthcare Provider Details

I. General information

NPI: 1023626413
Provider Name (Legal Business Name): AMSTERDAM, WEISGOLD, BAUMGARTEN, INGBER, & FRAIMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S BROAD ST STE 2000
PHILADELPHIA PA
19110-1009
US

IV. Provider business mailing address

100 S BROAD ST STE 2000
PHILADELPHIA PA
19110-1009
US

V. Phone/Fax

Practice location:
  • Phone: 215-568-8130
  • Fax:
Mailing address:
  • Phone: 215-568-8130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: HOWARD FRAIMAN
Title or Position: MANAGING PARTNER
Credential:
Phone: 215-568-8130