Organization
UROLOGIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY MILLER (OFFCE MANAGER)
(610) 667-3021
Entity
Organization
Contact information
Practice address
301 E CITY AVE, STE 210, BALA CYNWYD, PA 19004-1734
(610) 667-3020
(610) 667-1817
Mailing address
301 E CITY AVE, STE 210, BALA CYNWYD, PA 19004-1734
(610) 667-3020
(610) 667-1817
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
OS003582L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011960660005
—
PA
Enumeration date
06/14/2005
Last updated
08/22/2020
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