Healthcare Provider Details
I. General information
NPI: 1013946995
Provider Name (Legal Business Name): HAROLD J. MILSTEIN, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 JAMESTOWN ST SUITE 206
PHILADELPHIA PA
19128-1751
US
IV. Provider business mailing address
525 JAMESTOWN ST SUITE 206
PHILADELPHIA PA
19128-1751
US
V. Phone/Fax
- Phone: 215-483-3666
- Fax: 215-483-4207
- Phone: 215-483-3666
- Fax: 215-483-4207
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | MD020207E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | OS008600L |
| License Number State | PA |
VIII. Authorized Official
Name:
HAROLD
J
MILSTEIN
Title or Position: OWNER
Credential: M.D.
Phone: 215-483-3666