Provider Demographics
NPI:1245202076
Name:DERMATOLOGY ASSOCIATES OF LEBANON LTD
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF LEBANON LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMSAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:KURBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-273-8091
Mailing Address - Street 1:845 NORMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7445
Mailing Address - Country:US
Mailing Address - Phone:717-273-8091
Mailing Address - Fax:717-273-1824
Practice Address - Street 1:845 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7445
Practice Address - Country:US
Practice Address - Phone:717-273-8091
Practice Address - Fax:717-273-1824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC32885Medicare UPIN