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General NPI Number Information
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NPI Number | 1902882715
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Entity Type | Individual
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Provider Name | PHILLIP C GINSBERG D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 5401 OLD YORK RD SUITE 200
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3030
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Country | US
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Telephone | 215-456-1177
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Fax | 215-457-1200
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Provider Business Mailing Address
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Address Line | 5401 OLD YORK RD SUITE 200
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3030
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Country | US
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Telephone | 215-456-1177
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Fax | 215-457-1200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OS004644L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | OS004644L
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License Number State | PA
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