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General NPI Number Information
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NPI Number | 1821328543
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Entity Type | Organization
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Legal Business Name | BACK OFFICE MANAGEMENT SERVICES LLC
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 2509 S 4TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19148-4712
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Country | US
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Telephone | 718-972-5000
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Fax | 718-972-3774
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Provider Business Mailing Address
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Address Line | 1335 54TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-4220
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Country | US
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Telephone | 718-972-5000
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Fax | 718-972-3774
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Authorized Official
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Title or Position | OWNER
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Name | ALAN TAJERSTEIN
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Credential | DPM
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Telephone | 718-972-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 004639
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License Number State | NY
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