Provider Demographics
NPI:1023044609
Name:DOYLESTOWN GYNECOLOGY, LLC
Entity Type:Organization
Organization Name:DOYLESTOWN GYNECOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-348-2992
Mailing Address - Street 1:1456 FERRY RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2391
Mailing Address - Country:US
Mailing Address - Phone:215-348-2992
Mailing Address - Fax:215-348-2052
Practice Address - Street 1:1456 FERRY RD
Practice Address - Street 2:SUITE 402
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2391
Practice Address - Country:US
Practice Address - Phone:215-348-2992
Practice Address - Fax:215-348-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019294790001Medicare ID - Type UnspecifiedGROUP ID
PA082961Medicare ID - Type UnspecifiedGROUP NUMBER