Healthcare Provider Details

I. General information

NPI: 1831190560
Provider Name (Legal Business Name): EAST MOUNTAIN UROLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 MAIN ST
SWOYERSVILLE PA
18704-1318
US

IV. Provider business mailing address

1212 MAIN ST
SWOYERSVILLE PA
18704-1318
US

V. Phone/Fax

Practice location:
  • Phone: 570-829-1221
  • Fax: 570-829-4468
Mailing address:
  • Phone: 570-829-1221
  • Fax: 570-829-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN J KURZWEIL
Title or Position: PRESIDENT
Credential: MD
Phone: 570-829-1221