Provider Demographics
NPI:1639124720
Name:COLON AND RECTAL ASSOCIATES, LTD
Entity Type:Organization
Organization Name:COLON AND RECTAL ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:IRLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-517-1250
Mailing Address - Street 1:1235 OLD YORK RD STE G20
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3839
Mailing Address - Country:US
Mailing Address - Phone:215-517-1250
Mailing Address - Fax:215-517-0821
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:SUITE G20
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3800
Practice Address - Country:US
Practice Address - Phone:215-517-1250
Practice Address - Fax:215-517-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA181603Medicare ID - Type UnspecifiedPROVIDER NUMBER