Healthcare Provider Details

I. General information

NPI: 1679143036
Provider Name (Legal Business Name): NOAH KIRSHNER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD STE 1
WEST CHESTER PA
19380-4269
US

IV. Provider business mailing address

PO BOX 34990
BELFAST ME
04915-0627
US

V. Phone/Fax

Practice location:
  • Phone: 610-692-6280
  • Fax:
Mailing address:
  • Phone: 610-359-5672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberSC007198
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007198
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: