Organization
CLINICAL RENAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY G. MARCUS M.D. (CHIEF OPERATING OFFICER)
(610) 872-8501
Entity
Organization
Contact information
Practice address
30 MEDICAL CENTER BLVD, SUITE 303, UPLAND, PA 19013-3955
(610) 872-8501
(610) 872-5188
Mailing address
850 W RIO SALADO PKWY STE 201, TEMPE, AZ 85281-3812
(480) 480-8330
(480) 610-6198
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000760867-0013
—
PA
01
—
0032975000
PERSONAL CHOICE
PA
01
—
045319
KEYSTONE MERCY
PA
01
—
110372
BCBS PA
PA
01
—
CF3534
RAIL ROAD MEDICARE
PA
Enumeration date
05/25/2006
Last updated
11/30/2023
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