Provider Demographics
NPI:1588738017
Name:DAVID L TOPOLSKY MD
Entity type:Organization
Organization Name:DAVID L TOPOLSKY MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADM DIR
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-762-3129
Mailing Address - Street 1:230 S BROAD ST
Mailing Address - Street 2:15TH FLR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 S BROAD ST
Practice Address - Street 2:15TH FLR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4121
Practice Address - Country:US
Practice Address - Phone:215-762-7735
Practice Address - Fax:215-762-8857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031196E332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
3985340OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA000637086001Medicaid