PEDS DERM LLC (NPI# 1548764723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548764723 |
| Entity Type | Organization |
| Organization Name | PEDS DERM LLC |
| Practice Address |
830 Old Lancaster Rd Bldg North Bryn Mawr PA 19010-3118 |
| Mailing Address |
24 N Bryn Mawr Ave # 284 Bryn Mawr PA 19010-3304 |
| Practice Telephone | 6106424517 |
| Mailing Telephone | 6106424517 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |
| Authorized Official Name | DR. ANDREW CHARLES KRAKOWSKI (PRESIDENT) |
| Authorized Official Telephone | 6106424517 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
Allopathic & Osteopathic Physicians |
| Street Address |
830 OLD LANCASTER RD BLDG NORTH |
| City | BRYN MAWR |
| State | PA |
| Zip Code | 19010-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003462169 | Nada Farag | Dentist | 275 S Bryn Mawr Ave., #d04, Bryn Mawr, PA 19010 | 2019-08-14 |
| 1841764669 | For Eyes Optical of Pa | Optometrist | 1211 W Lancaster Ave, Rosemont, PA 19010 | 2019-01-15 |
| 1205355617 | Julia Peyton Vollmer | Student in an Organized Health Care Education/Training Program | 415 S Ithan Ave, Bryn Mawr, PA 19010 | 2017-09-18 |
| 1235657081 | Megan Christine Rosenblatt | Nurse Practitioner | 925 W Lancaster Ave Ste 210, Bryn Mawr, PA 19010 | 2017-08-31 |
| 1720511561 | Victoria Mckenna | Nurse Practitioner | 830 Old Lancaster Rd Ste 300, Bryn Mawr, PA 19010 | 2017-04-08 |
| 1922544014 | Andrew John D'amico | Behavioral Analyst | 1030 East Lancaster Ave., Suite L-10, Bryn Mawr, PA 19010 | 2017-01-12 |
| 1487105615 | Primal Physical Therapy,llc | Physical Therapist | 1111 E Lancaster Ave, Bryn Mawr, PA 19010 | 2016-10-24 |
| 1730636234 | Denise Lindsay Currier | Optometrist | 1062 E. Lancaster Ave, Suite 15d, Rosemont, PA 19010 | 2016-09-01 |
| 1518353754 | Elise Paquin | Student in an Organized Health Care Education/Training Program | 135 S Bryn Mawr Ave Ste 205, Bryn Mawr, PA 19010 | 2015-04-14 |
| 1679980064 | Main Line Counseling Partners | Social Worker | 1084 E. Lancaster Avenue, Bryn Mawr, PA 19010 | 2014-07-17 |
| Find all providers in zip 19010 | ||||
| Taxonomy Code | 207NP0225X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Pediatric Dermatology |
| A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: changed definition, added source] Additional Resources: American Board of Dermatology, 2007, http://www.abderm.org/ A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760932099 | Childrens Community Pediatrics | Dermatology | 4055 Monroeville Blvd Bldg 1, Monroeville, PA 15146-2522 | 2016-10-11 |
| 1174909527 | Pediatric Dermatology Associates of Erie LLC | Dermatology | 3405 State St, Erie, PA 16508-2831 | 2015-08-08 |
| 1952718215 | Children's Community Pediatrics | Dermatology | 205 Millers Run Rd Fl 3, Bridgeville, PA 15017-1348 | 2014-07-18 |
| 1659851269 | Cathryn Sibbald | Dermatology | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2018-08-14 |
| 1851652770 | Scarlett Boulos | Dermatology | 3401 Civic Center Blvd, Division of Pediatric Dermatology, Philadelphia, PA 19104-4319 | 2012-06-07 |
| 1619264660 | Jenna Streicher | Dermatology | 3401 Civic Center Blvd, Division of Dermatology, Philadelphia, PA 19104-4319 | 2011-06-28 |
| 1225359680 | Markus Daniel Boos | Dermatology | 3535 Market St, Division of Dermatology, 2nd Floor, Philadelphia, PA 19104 | 2010-06-18 |
| 1831359330 | Emily M Berger | Dermatology | 3550 Market St, 2nd Floor, Philadelphia, PA 19104-3329 | 2008-06-10 |
| 1023200045 | Melinda Jen | Dermatology | 3550 Market St Fl 2, Children's Hospital of Philadelphia - Dermatology Div, Philadelphia, PA 19104-3366 | 2007-08-14 |
| 1457568404 | Marissa Jill Perman | Dermatology | 3550 Market St Fl 2, Children's Hospital of Philadelphia - Dermatology Div, Philadelphia, PA 19104-3366 | 2007-05-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.