Healthcare Provider Details

I. General information

NPI: 1215140504
Provider Name (Legal Business Name): AMIR TOIB M.D, M.SC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 A ST
PHILADELPHIA PA
19134-1043
US

IV. Provider business mailing address

611 HARVARD RD
BALA CYNWYD PA
19004-2214
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5000
  • Fax:
Mailing address:
  • Phone: 314-448-9744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD443041
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: