Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | P0001587 | FL |
N | 222Z00000X | Podiatrist | P0001587 | FL |
Y | 213E00000X | Podiatrist | SC002590L | PA |
Y | 222Z00000X | Podiatrist | SC002590L | PA |
NPI | 1003816190 |
---|---|
Provider Name | Dr. Carl Richard Ginsberg |
First Address | Jenkintown, PA 19046-2901 |
Second Address | Jenkintown, PA 19046-2901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 31/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0048290000 | KEYSTONE (01) | PA |
00922956/0003 | (05) | PA |
T30413 | (02) |