Daniel J Licht M.D.

NPI 1023032539 - Pediatrics - 208000000X

NPI Details
NPI 1023032539
Gender Male
Enumeration Date 07/27/2006
Last Updated 10/23/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - NEUROLOGY
PHILADELPHIA PA, 19104-4319, US
Phone (215) 590-1719
Fax (215) 590-1771
Business Location
100 E PENN SQ
9TH FLOOR
PHILADELPHIA PA, 19107-3323, US
Phone (267) 425-9258
Fax (267) 425-9299
Toxanomy
Taxonomy Code 208000000X
License State Pennsylvania
License Number MD068489L
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According to our database, Daniel J Licht M.D. NPI is 1023032539, taxonomy code is 208000000X and license number is MD068489L, license state is located at Pennsylvania. Daniel J Licht M.D. physically located at 3401 Civic Center Blvd, Philadelphia PA, 19104-4319. NPI Number Daniel J Licht M.D. has the Individual type.

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1023032539 NPI number is provided on an as is basis without warranty of any kind. 1023032539 is maintained by the National Plan & Provider Enumeration System. The contents of Daniel J Licht M.D. are for informational purposes only.