Healthcare Provider Details

I. General information

NPI: 1962692608
Provider Name (Legal Business Name): BUX-MONTOB/GYN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 HORIZON CIR SUITE 103
CHALFONT PA
18914-3971
US

IV. Provider business mailing address

708 N SHADY RETREAT RD SUITE #7
DOYLESTOWN PA
18901-2503
US

V. Phone/Fax

Practice location:
  • Phone: 267-308-0430
  • Fax: 267-308-0434
Mailing address:
  • Phone: 267-308-0430
  • Fax: 267-308-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: NILA K SENDZIK
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 267-308-0430