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General NPI Number Information
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NPI Number | 1437190238
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Entity Type | Organization
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Legal Business Name | DR SAMUEL LIZERBRAM & DR NEIL M COHEN PC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 12000 BUSTLETON AVE SUITE 102
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City | PHILADELPHIA
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State | PA
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Zip | 19116-2151
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Country | US
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Telephone | 215-673-7600
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Fax | 215-673-1894
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Provider Business Mailing Address
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Address Line | 12000 BUSTLETON AVE SUITE 102
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City | PHILADELPHIA
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State | PA
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Zip | 19116-2151
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Country | US
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Telephone | 215-673-7600
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Fax | 215-673-1894
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMUEL LIZERBRAM
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Credential | D.O
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Telephone | 215-673-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS002814L
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License Number State | PA
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