Organization
UROLOGIC CONSULTANTS OF SOUTHEASTERN PENNSYLVANIA LLP
Active
Other names
Urologic Consultants of SE PA LLP
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY MILLER (PRACTICE MANAGER)
(610) 667-3020
Entity
Organization
Contact information
Practice address
1 PRESIDENTIAL BLVD, SUITE 100, BALA CYNWYD, PA 19004-1017
(610) 667-3020
(610) 667-1817
Mailing address
1 PRESIDENTIAL BLVD, SUITE 100, BALA CYNWYD, PA 19004-1017
(610) 667-3020
(610) 667-1817
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
PA
2085R0001X
Radiation Oncology Physician
—
PA
208800000X
Urology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018621670001
—
PA
Enumeration date
12/04/2006
Last updated
10/08/2014
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