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General NPI Number Information
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NPI Number | 1821160011
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF DELAWARE VALLEY PC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 3501 W CHESTER PIKE UNIT 205
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3704
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Country | US
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Telephone | 610-325-5553
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Fax | 610-325-5532
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Provider Business Mailing Address
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Address Line | 3501 W CHESTER PIKE STE 202
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3708
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Country | US
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Telephone | 610-325-5553
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Fax | 610-325-5532
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAPHNE ELIZABETH COCH BENSTOCK
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Credential | MD
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Telephone | 610-325-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD07523L
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License Number State | PA
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