Provider Demographics
NPI:1205986379
Name:OXFORD VALLEY VEIN & LASER CENTER
Entity type:Organization
Organization Name:OXFORD VALLEY VEIN & LASER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-664-4972
Mailing Address - Street 1:3 BLANCOYD RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1801
Mailing Address - Country:US
Mailing Address - Phone:610-664-4972
Mailing Address - Fax:610-664-4972
Practice Address - Street 1:370 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 508
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1840
Practice Address - Country:US
Practice Address - Phone:215-741-4034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD005567E2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB96169Medicare UPIN