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General NPI Number Information
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NPI Number | 1497700363
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Entity Type | Organization
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Legal Business Name | PHILADELPHIA UROLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 1015 CHESTNUT ST STE 405
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4304
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Country | US
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Telephone | 215-563-1199
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Fax | 215-563-1783
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Provider Business Mailing Address
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Address Line | 1015 CHESTNUT ST STE 405
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4304
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Country | US
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Telephone | 215-563-1199
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Fax | 215-563-1783
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ETHEL ROSENBERG
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Credential |
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Telephone | 215-563-1199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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