SUSAN J BACK M.D. NPI 1902936669

NPI Information

NPI: 1902936669
Provider Name: SUSAN J BACK, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - RADIOLOGY
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 590-7000
Get Directions

Susan J Back, M.D. is a diagnostic radiology radiology in Philadelphia, PA with 20 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Susan J Back, M.D. NPI is 1902936669. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2004

The provider's business location address is:

3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - RADIOLOGY
PHILADELPHIA, PA
ZIP 19104-319
Phone: (215) 590-7000
Fax: (215) 590-9348

The NPI 1902936669 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 5/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	2085B0100X	Radiology	Body Imaging	MT184561	PENNSYLVANIA	No
3	208000000X	Pediatrics		MD429646	PENNSYLVANIA	No
4	2080P0204X	Pediatrics	Pediatric Emergency Medicine	MD429646	PENNSYLVANIA	No
5	2085R0202X	Radiology	Diagnostic Radiology	MD429646	PENNSYLVANIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »