Provider Demographics
NPI:1720315765
Name:FPM UROGYNECOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:FPM UROGYNECOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-435-9575
Mailing Address - Street 1:3050 HAMILTON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3628
Mailing Address - Country:US
Mailing Address - Phone:610-435-9575
Mailing Address - Fax:610-435-2763
Practice Address - Street 1:3050 HAMILTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3628
Practice Address - Country:US
Practice Address - Phone:610-435-9575
Practice Address - Fax:610-435-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical