Healthcare Provider Details

I. General information

NPI: 1306043617
Provider Name (Legal Business Name): UROLOGY HEALTH SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 BYBERRY RD STE 1204
HUNTINGDON VALLEY PA
19006
US

IV. Provider business mailing address

PO BOX 1287
BLUE BELL PA
19422-0410
US

V. Phone/Fax

Practice location:
  • Phone: 215-947-4105
  • Fax: 215-947-2015
Mailing address:
  • Phone: 215-947-4105
  • Fax: 215-947-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LARRY A CUTLER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 215-517-1100