Provider Demographics
NPI:1811967599
Name:UROLOGICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:UROLOGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIOCCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-335-5355
Mailing Address - Street 1:8100 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2900
Mailing Address - Country:US
Mailing Address - Phone:215-335-5355
Mailing Address - Fax:215-335-5352
Practice Address - Street 1:2137 WELSH RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-4963
Practice Address - Country:US
Practice Address - Phone:215-698-7333
Practice Address - Fax:215-673-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006749560005Medicaid
PAUR100338Medicare ID - Type Unspecified