Provider Demographics
NPI:1083684344
Name:MILSTEIN, HAROLD JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:JACOB
Last Name:MILSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:525 JAMESTOWN ST STE 206
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1751
Practice Address - Country:US
Practice Address - Phone:215-482-7546
Practice Address - Fax:215-482-7548
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020207E207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000734007Medicaid
PA050170Medicare ID - Type UnspecifiedHAZLETON OFFICE
PAC30270Medicare UPIN
PA106145Medicare PIN