Healthcare Provider Details

I. General information

NPI: 1275582017
Provider Name (Legal Business Name): ALAN BRUCE ZUBROW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN 3601 A ST
PHILADELPHIA PA
19134
US

IV. Provider business mailing address

1431 BARTON DR
FORT WASHINGTON PA
19034-2823
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5202
  • Fax:
Mailing address:
  • Phone: 215-641-9682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD020443E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: