Basic Information
| Provider Information | |||||||||
| NPI: | 1033301023 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WERBER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 331 N YORK RD | ||||||||
| Address2: | BUILDING C | ||||||||
| City: | HATBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190402033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156725260 | ||||||||
| FaxNumber: | 2156725287 | ||||||||
| Practice Location | |||||||||
| Address1: | 3260 TILLMAN DR | ||||||||
| Address2: | #120 | ||||||||
| City: | BENSALEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190202029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153058834 | ||||||||
| FaxNumber: | 2673320323 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2007 | ||||||||
| LastUpdateDate: | 08/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 169866 | NY | Y | Allopathic & Osteopathic Physicians | Dermatology | 207NS0135X | 169866 | NY | N | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology |
No ID Information.