Organization Active NPI

Laurie Tolin, MD

  • Dermatology Physician
  • Ardmore, PA
National Provider Identifier
1285775197
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD016388E Issued in PA
Legal business name
LAURIE TOLIN, MD
Practice address
100 Church Rd
Ardmore, PA 19003-2316
Phone
(610) 642-1806
Fax
(610) 645-5783
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ellie Suder
Title
Billing Manager
Phone
(215) 723-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD016388E PA Primary

Addresses

Primary practice location

100 Church Rd
Ardmore, PA 19003-2316

Mailing address

100 Church Rd
Ardmore, PA 19003-2316
Phone (610) 642-1806

Other identifiers 1

IdentifierTypeStateIssuer
0031830OtherPAAETNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1285775197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHURCH RD",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032316",
            "telephone_number": "610-642-1806",
            "fax_number": "610-645-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHURCH RD",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032316",
            "telephone_number": "610-642-1806",
            "fax_number": "610-645-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURIE TOLIN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "SUDER",
        "authorized_official_first_name": "ELLIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "215-723-2333"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD016388E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0031830",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.