Pine Street Dermatology, Pc
LBN: Pine Street Dermatology, Pc
Pine Street Dermatology, Pc is an health care organization with primary practice located at 1233 Locust St. Suite 101, Philadelphia PA 19107. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Pine Street Dermatology, Pc can be contacted via phone (215) 735-2636, or through Covello, Seana via phone (215) 574-9101.
Contact Information
Primary practice address
1233 Locust St. Suite 101
Philadelphia PA 19107
Phone: (215) 735-2636
Fax: (215) 735-2634
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD067435L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD067435L | Pennsylvania |
Profile Details
| NPI number | 1396822870 |
|---|---|
| LBN Legal business name | Pine Street Dermatology, Pc |
| DBA Doing business as | |
| Authorized official | Covello, Seana Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | May 11th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396822870 | NPPES |
| Pennsylvania | Other | 2146941000 | IBC |
| Pennsylvania | Other | 1458723 | IBC |
| Pennsylvania | Other | 3150557 | IBC |
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