Healthcare Provider Details

I. General information

NPI: 1558421479
Provider Name (Legal Business Name): CHESTER COUNTY CARDIOLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLD FERN HILL RD BLDG A, STE 5
WEST CHESTER PA
19380-4269
US

IV. Provider business mailing address

915 OLD FERN HILL RD BLDG A, STE 5
WEST CHESTER PA
19380-4269
US

V. Phone/Fax

Practice location:
  • Phone: 610-696-2850
  • Fax: 610-696-2579
Mailing address:
  • Phone: 610-696-2850
  • Fax: 610-696-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW D NUSSBAUM
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 610-696-2850