Provider Demographics
NPI:1548691942
Name:LANSDALE INSTITUTE OF PLASTIC SURGERY PC
Entity type:Organization
Organization Name:LANSDALE INSTITUTE OF PLASTIC SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-855-1122
Mailing Address - Street 1:1101 S BROAD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5393
Mailing Address - Country:US
Mailing Address - Phone:215-855-1122
Mailing Address - Fax:215-855-1988
Practice Address - Street 1:1101 S BROAD ST STE 100
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5393
Practice Address - Country:US
Practice Address - Phone:215-855-1122
Practice Address - Fax:215-855-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438251208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty