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General NPI Number Information
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NPI Number | 1629027388
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Entity Type | Organization
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Legal Business Name | COLON RECTAL SURGERY ASSOCIATES PC
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 1255 S CEDAR CREST BLVD SUITE 3900
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City | ALLENTOWN
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State | PA
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Zip | 18103-6256
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Country | US
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Telephone | 610-402-1095
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Fax | 610-435-5003
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Provider Business Mailing Address
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Address Line | 1255 S. CEDAR CREST BLVD SUITE 3900
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City | ALLENTOWN
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State | PA
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Zip | 18103-6256
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Country | US
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Telephone | 484-788-0852
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Fax | 610-435-5003
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | MIKHAIL I RAKHMANINE
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Credential | M.D.
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Telephone | 484-788-0840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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