Provider Demographics
NPI:1033630777
Name:LOWER BUCKS GYNECOLOGY LLC
Entity Type:Organization
Organization Name:LOWER BUCKS GYNECOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SIDAT
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMARATNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-788-7700
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-1245
Mailing Address - Country:US
Mailing Address - Phone:215-788-7700
Mailing Address - Fax:215-788-7705
Practice Address - Street 1:501 BATH RD STE 210
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3101
Practice Address - Country:US
Practice Address - Phone:714-488-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty