Ackerman, Stacey L

Ackerman, Stacey L is an individual health care provider with primary practice located at 1930 S Broad St Unit 9 , Philadelphia PA 19145-2328. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Ackerman, Stacey L can be contacted via phone (215) 339-8100.

Contact Information

Primary practice address
1930 S Broad St Unit 9 Philadelphia PA 19145-2328
Phone: (215) 339-8100
Fax: (215) 339-8103
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD031968E Pennsylvania
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 25MA04606000 New Jersey

Profile Details

NPI number 1508868498
LBN Legal business name Ackerman, Stacey L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jan 13th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508868498 NPPES
Pennsylvania MEDICAID 0903906

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