Provider Demographics
NPI:1578614566
Name:PLASTIC & HAND SURGERY LTD
Entity Type:Organization
Organization Name:PLASTIC & HAND SURGERY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROBYN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-641-2300
Mailing Address - Street 1:467 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3420
Mailing Address - Country:US
Mailing Address - Phone:215-641-2300
Mailing Address - Fax:215-628-2411
Practice Address - Street 1:467 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3420
Practice Address - Country:US
Practice Address - Phone:215-641-2300
Practice Address - Fax:215-628-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009383E2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006365520003Medicaid
PAE55502Medicare UPIN
PA0006365520003Medicaid