Basic Information
| Provider Information | |||||||||
| NPI: | 1487106720 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VLADIMIR IOFFE MD, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1903 CORBRIDGE LN | ||||||||
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| City: | MONKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211112027 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 FAME AVE | ||||||||
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| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173311587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176467011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2016 | ||||||||
| LastUpdateDate: | 11/03/2016 | ||||||||
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| AuthorizedOfficialLastName: | IOFFE | ||||||||
| AuthorizedOfficialFirstName: | VLADIMIR | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4105916910 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | MD445025 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.