1184750614 NPI number — BUCKS CNTY ALLERGY & ASTHMA ASSC PC

Table of content: (NPI 1184750614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184750614 NPI number — BUCKS CNTY ALLERGY & ASTHMA ASSC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUCKS CNTY ALLERGY & ASTHMA ASSC 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:
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:
1184750614
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
370 MIDDLETOWN BOULEVARD
Provider Second Line Business Mailing Address:
QXFORD SQUARE SUITE 504
Provider Business Mailing Address City Name:
LANGHORNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19047-1840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-750-0315
Provider Business Mailing Address Fax Number:
215-702-1062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
370 MIDDLETOWN BOULEVARD QXFORD SQUARE SUITE 504
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-750-0315
Provider Business Practice Location Address Fax Number:
215-702-1062
Provider Enumeration Date:
02/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RICHARDS
Authorized Official First Name:
KARIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
MEDICAL BILLER
Authorized Official Telephone Number:
215-750-0315

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  OS003700L , 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: 2114609000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2114609000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".