Provider Demographics
NPI:1457332314
Name:BUCKS DERMATOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:BUCKS DERMATOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:WORTZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-752-4020
Mailing Address - Street 1:402 MIDDLETOWN BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1818
Mailing Address - Country:US
Mailing Address - Phone:215-752-4020
Mailing Address - Fax:215-752-8807
Practice Address - Street 1:402 MIDDLETOWN BLVD
Practice Address - Street 2:STE 210
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1818
Practice Address - Country:US
Practice Address - Phone:215-752-4020
Practice Address - Fax:215-752-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA719795E48Medicare PIN
085179Medicare PIN
PA669770E48Medicare PIN
PA421434E48Medicare PIN
PA483583E48Medicare PIN
PA114162E48Medicare PIN