1114988748 NPI number — DR. SCOTT H HERBERT M.D.

Table of content: DR. SCOTT H HERBERT M.D. (NPI 1114988748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114988748 NPI number — DR. SCOTT H HERBERT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERBERT
Provider First Name:
SCOTT
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114988748
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13700-1132
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19191-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-425-4497
Provider Business Mailing Address Fax Number:
302-733-0854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 OLD YORK RD
Provider Second Line Business Practice Location Address:
DEPT OF RADIATION ONCOLOGY
Provider Business Practice Location Address City Name:
ABINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19001-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-481-2800
Provider Business Practice Location Address Fax Number:
215-481-6741
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  MD042045E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 920000680 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: HE0000542624 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0116803000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 35582 . This is a "AETNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001244664 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0116803000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1032219 . This is a "KEYSTONE MERCY HEALTH PLA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com