Provider Demographics
NPI:1437557329
Name:BCGI PATHOLOGY
Entity Type:Organization
Organization Name:BCGI PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-321-7221
Mailing Address - Street 1:301 OXFORD VALLEY RD
Mailing Address - Street 2:#701
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7706
Mailing Address - Country:US
Mailing Address - Phone:215-321-7221
Mailing Address - Fax:215-321-9109
Practice Address - Street 1:301 OXFORD VALLEY RD
Practice Address - Street 2:#701
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7706
Practice Address - Country:US
Practice Address - Phone:215-321-7221
Practice Address - Fax:215-321-9109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUCKS COUNTY GASTROENTEROLOGY ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430131207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063520096OtherBUCKS COUNTY GASTROENTEROLOGY NPI