Provider Demographics
NPI:1407870801
Name:BUCKS COUNTY CENTER FOR VEIN MEDICINE
Entity Type:Organization
Organization Name:BUCKS COUNTY CENTER FOR VEIN MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-750-7442
Mailing Address - Street 1:1205 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:STE 106
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-750-7442
Mailing Address - Fax:215-757-5870
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD
Practice Address - Street 2:STE 106
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-750-7442
Practice Address - Fax:215-757-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0566810000OtherIBC
PA0849150001OtherMEDICARE TRAVELERS
PA176453OtherOXFORD
PA117105OtherAETNA
PA322061BOtherKEYSTONE MERCY
PA728444OtherBLUE SHIELD
PA728444OtherBLUE SHIELD
PA176453OtherOXFORD