Healthcare Provider Details
I. General information
NPI: 1396883815
Provider Name (Legal Business Name): ESKRA PLASTIC SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1590 MEDICAL DR SUITE A
POTTSTOWN PA
19464-3247
US
IV. Provider business mailing address
1590 MEDICAL DR SUITE A
POTTSTOWN PA
19464-3247
US
V. Phone/Fax
- Phone: 610-323-2230
- Fax: 610-323-8215
- Phone: 610-323-2230
- Fax: 610-323-8215
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BENJAMIN
D
ESKRA
Title or Position: OWNER
Credential: M.D.
Phone: 610-323-2230