Provider Demographics
NPI:1487626230
Name:STEIN, HERMINE (DO)
Entity Type:Individual
Prefix:
First Name:HERMINE
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:1330 POWELL ST STE 409
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3351
Practice Address - Country:US
Practice Address - Phone:484-622-7510
Practice Address - Fax:484-622-7520
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005967L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
040655Medicare ID - Type Unspecified
D83962Medicare UPIN
80178708Medicare PIN