Basic Information
Provider Information
NPI: 1215140504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOIB
FirstName: AMIR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D, M.SC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 HARVARD RD
Address2:  
City: BALA CYNWYD
State: PA
PostalCode: 190042214
CountryCode: US
TelephoneNumber: 3144489744
FaxNumber:  
Practice Location
Address1: 3601 A ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191341043
CountryCode: US
TelephoneNumber: 2154275000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/07/2007
LastUpdateDate: 07/01/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202XMD443041PAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


Home