Healthcare Provider Details

I. General information

NPI: 1487698023
Provider Name (Legal Business Name): BENJAMIN LI-PING HSU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 N POWELTON AVE 2ND FLOOR
PHILADELPHIA PA
19104-2640
US

IV. Provider business mailing address

3910 N POWELTON AVE 2ND FLOOR
PHILADELPHIA PA
19104-2640
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-4333
  • Fax: 215-349-8900
Mailing address:
  • Phone: 215-662-4333
  • Fax: 215-349-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD064569L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: