Suburban Multispecialty Limited, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS-009268L Issued in PA

Legal business name

SUBURBAN MULTISPECIALTY LIMITED, LLC

Practice address

1 Belmont Avenue
Suite 416
Bala Cynwyd, PA 19004-1607

Phone

(610) 667-4080

Fax

(610) 667-2748

NPI assigned

Sep 9, 2014

Last updated

Sep 9, 2014By 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

Mrs. Dina Jean Dubrow

Title

Practice Manager

Phone

(610) 667-4080

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1962803031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BELMONT AVENUE",
            "address_2": "SUITE 416",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041607",
            "telephone_number": "610-667-4080",
            "fax_number": "610-667-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BELMONT AVENUE",
            "address_2": "SUITE 416",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041607",
            "telephone_number": "610-667-4080",
            "fax_number": "610-667-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN MULTISPECIALTY LIMITED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "DUBROW",
        "authorized_official_first_name": "DINA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "610-667-4080",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS-009268L",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "PA",
            "license": "OS.015962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.