Organization
SUBURBAN UROLOGICAL, PC
Active
Other names
Highland Urology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT D MINO MD (PRESIDENT)
(215) 884-7114
Entity
Organization
Contact information
Practice address
3 VILLAGE ROAD, SUITE 100, HORSHAM, PA 19044-3812
(215) 884-7114
(215) 884-7147
Mailing address
3 VILLAGE ROAD, SUITE 100, HORSHAM, PA 19044-3812
(215) 884-7114
(215) 884-7147
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011791720001
—
PA
Enumeration date
03/15/2007
Last updated
09/15/2010
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