Provider Demographics
NPI:1952344731
Name:UROLOGY CENTER OF CHESTER COUNTY P C
Entity type:Organization
Organization Name:UROLOGY CENTER OF CHESTER COUNTY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-692-4270
Mailing Address - Street 1:915 OLD FERN HILL RD
Mailing Address - Street 2:BLDG.,BSUITE 202
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4269
Mailing Address - Country:US
Mailing Address - Phone:610-692-4270
Mailing Address - Fax:610-692-2566
Practice Address - Street 1:915 OLD FERN HILL RD
Practice Address - Street 2:BLDG.,BSUITE 202
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4269
Practice Address - Country:US
Practice Address - Phone:610-692-4270
Practice Address - Fax:610-692-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG88101Medicare UPIN
PAC33224Medicare UPIN
PAF86922Medicare UPIN