Ackerman, Bruce Irwin

Ackerman, Bruce Irwin is an sole proprietor health care provider with primary practice located at 2417 Welsh Road Suite 21 #240, Philadelphia PA 19114. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Ackerman, Bruce Irwin can be contacted via phone (215) 334-5700.

Contact Information

Primary practice address
2417 Welsh Road Suite 21 #240 Philadelphia PA 19114
Phone: (215) 334-5700
Fax: (215) 334-5774
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC002030L Pennsylvania

Profile Details

NPI number 1316945983
LBN Legal business name Ackerman, Bruce Irwin
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2005
Last updated Nov 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316945983 NPPES
Pennsylvania Other 5677430 AETNA INSURANCE ID#
Pennsylvania MEDICAID SC002030L15493 AETNA INSURANCE ID#
Pennsylvania MEDICAID 0054016601 AETNA INSURANCE ID#
Pennsylvania Other 0060614000 AETNA INSURANCE ID#

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