Provider Demographics
NPI:1982771861
Name:HERMAN, IRA NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:NEIL
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:221 S 12TH ST
Mailing Address - Street 2:N 801
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5556
Mailing Address - Country:US
Mailing Address - Phone:215-627-2659
Mailing Address - Fax:
Practice Address - Street 1:93 OLD YORK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3925
Practice Address - Country:US
Practice Address - Phone:215-885-3337
Practice Address - Fax:215-885-3090
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD038851-L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry