Peds Derm LLC

Primary specialty

Pediatric Dermatology PhysicianTaxonomy code 207NP0225X

Legal business name

PEDS DERM LLC

Practice address

830 Old Lancaster Rd BLDG North
Bryn Mawr, PA 19010-3118

Phone

(610) 642-4517

NPI assigned

Mar 21, 2018

Last updated

Mar 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Charles Krakowski, MDNPI 1962651679

Title

President

Phone

(610) 642-4517

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Charles Krakowski, MD

  • Dermatology Physician
  • Center Valley, PA
  • NPI 1962651679

  Pediatric Dermatology

  NPD Authorized official

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1548764723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N BRYN MAWR AVE # 284",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103304",
            "telephone_number": "610-642-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OLD LANCASTER RD BLDG NORTH",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103118",
            "telephone_number": "610-642-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDS DERM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "KRAKOWSKI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-642-4517",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Payne, DO
• Jeffrey Pearlman-Storch, D.M.D.
• Philip Y Pearson, MD
• Mary Elizabeth Pease, D.O.
• David I Pedowitz, MD
• Aleksandr Pekar, MD
• Catherine Josephine Pelczar-Wissner, M. D.
• James Ryan Pellechi, MD
• Nancy C. Peltz, APN
• Sreedhar Penagaluru, MD

• Pediatric Dermatology Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Pediatric Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.