Provider Demographics
NPI:1649290990
Name:UROLOGIC ASSOCIATES OF CHESTER COUNTY, INC..
Entity type:Organization
Organization Name:UROLOGIC ASSOCIATES OF CHESTER COUNTY, INC..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANVALKENBURGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-696-5227
Mailing Address - Street 1:1450 E. BOOT RD.
Mailing Address - Street 2:SUITE 600 B
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5698
Mailing Address - Country:US
Mailing Address - Phone:610-696-5227
Mailing Address - Fax:610-431-6649
Practice Address - Street 1:1450 E. BOOT RD.
Practice Address - Street 2:SUITE 600 B
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5698
Practice Address - Country:US
Practice Address - Phone:610-696-5227
Practice Address - Fax:610-431-6649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty