Healthcare Provider Details

I. General information

NPI: 1174821136
Provider Name (Legal Business Name): CARDIOLOGY CONSULTANTS OF PHILADELPHIA,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GREEN LANE SUITE 3
BRISTOL PA
19007
US

IV. Provider business mailing address

207 N BROAD ST 3RD FLOOR
PHILADELPHIA PA
19107-1500
US

V. Phone/Fax

Practice location:
  • Phone: 215-788-2011
  • Fax: 215-781-1975
Mailing address:
  • Phone: 215-463-5333
  • Fax: 215-463-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOS004249L
License Number StatePA

VIII. Authorized Official

Name: DR. KEVIN P FUREY
Title or Position: DOCTOR/CARDIOLOGIST
Credential: DO
Phone: 215-321-7400