Organization
NORTHEASTERN UROLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE SOLISH MD (PRESIDENT)
(215) 634-2900
Entity
Organization
Contact information
Practice address
2314 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4432
(215) 634-2900
(215) 634-5687
Mailing address
2314 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-4432
(215) 634-2900
(215) 634-5687
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008824760002
—
PA
01
—
0053477000
KEYSTONE
PW
01
—
06897
HEALTH PARTNERS
PA
01
—
076967
BLUE CROSS PA
PA
01
—
32522
KEYSTONE MERCY
PW
01
—
CM5670
RAILROAD MEDICARE
PA
Enumeration date
07/12/2006
Last updated
08/22/2020
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