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General NPI Number Information
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NPI Number | 1700976404
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Entity Type | Organization
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Legal Business Name | SUBURBAN MULTISPECIALTY LIMITED, LLC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 1 BELMONT AVE SUITE 416
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1617
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Country | US
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Telephone | 610-667-4080
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Fax | 610-667-2748
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Provider Business Mailing Address
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Address Line | 1 BELMONT AVE SUITE 416
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1617
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Country | US
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Telephone | 610-667-4080
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Fax | 610-667-2748
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ANDREW SCOTT KIRSCHNER
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Credential | D.O.
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Telephone | 610-667-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number |
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License Number State |
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