Ibs Centers for Advanced Food Allergy Testing, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD042406E Issued in PA

Legal business name

IBS CENTERS FOR ADVANCED FOOD ALLERGY TESTING, LLC

Practice address

1601 Walnut St
Suite 501
Philadelphia, PA 19102-2944

Phone

(215) 557-7430

Fax

(215) 661-0302

NPI assigned

Dec 12, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Michael Stierstorfer, M.D.

Title

President

Phone

(215) 557-7430

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418342400000",
    "number": "1316345085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST",
            "address_2": "SUITE 501",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022944",
            "telephone_number": "215-557-7430",
            "fax_number": "215-661-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST",
            "address_2": "SUITE 501",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022944",
            "telephone_number": "215-557-7430",
            "fax_number": "215-661-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBS CENTERS FOR ADVANCED FOOD ALLERGY TESTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-12",
        "last_updated": "2014-12-12",
        "status": "A",
        "authorized_official_last_name": "STIERSTORFER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-557-7430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD042406E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.