Healthcare Provider Details

I. General information

NPI: 1083627731
Provider Name (Legal Business Name): BUCKS COUNTY RADIOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HULST DR SUITE 708
MATAMORAS PA
18336-2115
US

IV. Provider business mailing address

1001 BRIGGS RD SUITE 210
MOUNT LAUREL NJ
08054-4100
US

V. Phone/Fax

Practice location:
  • Phone: 570-491-9200
  • Fax: 570-491-9201
Mailing address:
  • Phone: 856-231-4774
  • Fax: 856-231-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWWARD B. KESSLER
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 570-491-9200