Healthcare Provider Details

I. General information

NPI: 1538116637
Provider Name (Legal Business Name): BUCKS COUNTY GI ENDOSCOPIC SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1339 WOODBOURNE RD
LEVITTOWN PA
19057-1236
US

IV. Provider business mailing address

1339 WOODBOURNE RD
LEVITTOWN PA
19057-1236
US

V. Phone/Fax

Practice location:
  • Phone: 215-547-3441
  • Fax: 215-547-7172
Mailing address:
  • Phone: 215-547-7172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number2047
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT C GOLDSTEIN
Title or Position: OWNER
Credential: MD
Phone: 215-547-3441