Provider Demographics
NPI:1700976404
Name:SUBURBAN MULTISPECIALTY LIMITED, LLC
Entity Type:Organization
Organization Name:SUBURBAN MULTISPECIALTY LIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:KIRSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-667-4080
Mailing Address - Street 1:1 BELMONT AVE
Mailing Address - Street 2:SUITE 416
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1617
Mailing Address - Country:US
Mailing Address - Phone:610-667-4080
Mailing Address - Fax:610-667-2748
Practice Address - Street 1:1 BELMONT AVE
Practice Address - Street 2:SUITE 416
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1617
Practice Address - Country:US
Practice Address - Phone:610-667-4080
Practice Address - Fax:610-667-2748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty