Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD029093E | PA |
NPI | 1194738872 |
---|---|
Provider Name | Ira C Krafchin |
First Address | Kingston, PA 18704-0379 |
Second Address | S. Abington Twp, PA 18411-9304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 01/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B41938 | (02) |