1558311795 NPI number — HEARTCARE ASSOCIATES OF BUCKS COUNTY PC

Table of content: (NPI 1558311795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558311795 NPI number — HEARTCARE ASSOCIATES OF BUCKS COUNTY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEARTCARE ASSOCIATES OF BUCKS COUNTY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558311795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
240 MIDDLETOWN BLVD
Provider Second Line Business Mailing Address:
SUITE -201
Provider Business Mailing Address City Name:
LANGHORNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19047-1832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-752-9950
Provider Business Mailing Address Fax Number:
215-752-9781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 MIDDLETOWN BLVD
Provider Second Line Business Practice Location Address:
SUITE -201
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-752-9950
Provider Business Practice Location Address Fax Number:
215-752-9781
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KANSUPADA
Authorized Official First Name:
BINDUKUMAR
Authorized Official Middle Name:
C
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
215-752-9950

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03186 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 377800 . This is a "BLUE SHIELD OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017383970009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2012085 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30293 . This is a "KEYSTONE MERCY HEALTH PLA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 8569606 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0148266000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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