Provider Demographics
NPI:1043854292
Name:RW DERMATOLOGY
Entity type:Organization
Organization Name:RW DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-824-4400
Mailing Address - Street 1:2325 HERITAGE CENTER DR STE 119
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2325 HERITAGE CENTER DR STE 119
Practice Address - Street 2:
Practice Address - City:FURLONG
Practice Address - State:PA
Practice Address - Zip Code:18925-1262
Practice Address - Country:US
Practice Address - Phone:267-824-4400
Practice Address - Fax:267-824-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty