Provider Demographics
NPI:1639472061
Name:TOHICKON INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:TOHICKON INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-362-5157
Mailing Address - Street 1:1456 FERRY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2391
Mailing Address - Country:US
Mailing Address - Phone:267-362-5157
Mailing Address - Fax:267-362-5158
Practice Address - Street 1:1456 FERRY RD STE 400
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2391
Practice Address - Country:US
Practice Address - Phone:267-362-5157
Practice Address - Fax:267-362-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty