1891872313 NPI number — BUXMONT PODIATRY ASSOCIATES, P.C.

Table of content: (NPI 1891872313)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891872313 NPI number — BUXMONT PODIATRY ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUXMONT PODIATRY ASSOCIATES, P.C.
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:
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:
1891872313
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
399 YORK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARMINSTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18974-4516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-672-3222
Provider Business Mailing Address Fax Number:
215-672-6634

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
399 YORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARMINSTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18974-4516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-672-3222
Provider Business Practice Location Address Fax Number:
215-672-6634
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GORMAN
Authorized Official First Name:
JACK
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
215-672-3222

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  SC001284L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 037389009 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00023128000 . This is a "AMERHEALTH HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0002654 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 123710 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: BU179 . This is a "OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0023128000 . This is a "KEYSTONE BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02018 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P0071007 . This is a "TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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