Healthcare Provider Details

I. General information

NPI: 1164402806
Provider Name (Legal Business Name): HEATHER GOTTLIEB DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2189 SECOND STREET PIKE STE 200
NEWTOWN PA
18940-4134
US

IV. Provider business mailing address

102 PROGRESS DRIVE
DOYLESTOWN PA
18901-2516
US

V. Phone/Fax

Practice location:
  • Phone: 215-863-8864
  • Fax: 267-494-1541
Mailing address:
  • Phone: 215-863-8864
  • Fax: 267-494-1541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberOS010671L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: