Provider Demographics
NPI:1366406795
Name:FAERBER, ERIC N (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:N
Last Name:FAERBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1923
Mailing Address - Country:US
Mailing Address - Phone:610-525-6212
Mailing Address - Fax:
Practice Address - Street 1:3601 A ST
Practice Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1043
Practice Address - Country:US
Practice Address - Phone:215-427-5230
Practice Address - Fax:215-427-4378
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023448E2085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA085591Medicare ID - Type Unspecified
PAB35316Medicare UPIN