Healthcare Provider Details

I. General information

NPI: 1992740369
Provider Name (Legal Business Name): EMMA E FURTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 03/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE STREET 6 FOUNDERS
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

3400 SPRUCE STREET 6 FOUNDERS
PHILADELPHIA PA
19104-4206
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-6503
  • Fax:
Mailing address:
  • Phone: 215-662-6503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD035110E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberMD035110E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: