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General NPI Number Information
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NPI Number | 1225242738
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Entity Type | Organization
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Legal Business Name | HAND SURGICAL & REHABILITATION ASSOC., INC.
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 1841 HUNTINGDON PIKE
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-7712
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Country | US
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Telephone | 215-947-3606
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Fax | 215-947-6901
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Provider Business Mailing Address
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Address Line | 1841 HUNTINGDON PIKE
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-7712
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Country | US
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Telephone | 215-947-3606
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Fax | 215-947-6901
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK NISSENBAUM
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Credential | M.D.
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Telephone | 215-947-3606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | MD012063E
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License Number State | PA
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