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NPI Code Detail

MEDICARE: BARRI R ISKIN LCSW

MEDICARE: BARRI R ISKIN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCWO15290PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CWO15290OTHERPALIC CLIN SOCIAL WORKER

General Provider Information

NPI Number : 1780714261
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRI R ISKIN LCSW
Provider Business Mailing Address
First Line : 112 N BROAD ST
Second Line : 7TH FL
City : PHILADELPHIA
State : PA
Zip : 19102-1510
Country : US
Telephone Number : 215-568-0860
Fax Number : 215-568-0769
Provider Business Practice Location Address
First Line : 112 N BROAD ST
Second Line : 7TH FL
City : PHILADELPHIA
State : PA
Zip : 19102-1510
Country : US
Telephone Number : 215-568-0860
Fax Number : 215-568-0769
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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