Healthcare Provider Details

I. General information

NPI: 1356347389
Provider Name (Legal Business Name): HERBERT M ADLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 02/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 CHESTNUT ST STE 1000
PHILADELPHIA PA
19107-4310
US

IV. Provider business mailing address

1015 CHESTNUT STREET SUITE 1000
PHILADELPHIA PA
19107
US

V. Phone/Fax

Practice location:
  • Phone: 215-925-3385
  • Fax:
Mailing address:
  • Phone: 215-925-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMDO24920L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: