Healthcare Provider Details

I. General information

NPI: 1235175613
Provider Name (Legal Business Name): BUX-MONT ALLERGY & ASTHMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 W CHESTNUT ST STE 201
PERKASIE PA
18944-1307
US

IV. Provider business mailing address

711 LAWN AVE STE 6
SELLERSVILLE PA
18960-1508
US

V. Phone/Fax

Practice location:
  • Phone: 215-257-0000
  • Fax: 215-453-8223
Mailing address:
  • Phone: 215-257-5000
  • Fax: 215-453-8223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD072638L
License Number StatePA

VIII. Authorized Official

Name: WARDEN HWAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 215-257-5000