Healthcare Provider Details

I. General information

NPI: 1699166827
Provider Name (Legal Business Name): QSS PENNSYLVANIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1664 CHESTERTOWN RD
ALLENTOWN PA
18104-1629
US

IV. Provider business mailing address

145 US HIGHWAY 46 SUITE 304
WAYNE NJ
07470-6830
US

V. Phone/Fax

Practice location:
  • Phone: 973-894-1263
  • Fax: 888-972-3703
Mailing address:
  • Phone: 973-894-1263
  • Fax: 888-972-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: BARRY A COHEN
Title or Position: MEMBER OWNER
Credential: MD
Phone: 973-826-8285