Basic Information
| Provider Information | |||||||||
| NPI: | 1043207863 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UROCARE ASSOCIATES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 LAWN AVE | ||||||||
| Address2: | BLDG 2 | ||||||||
| City: | SELLERSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189601575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152571050 | ||||||||
| FaxNumber: | 2152573026 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 LAWN AVE | ||||||||
| Address2: | BLDG 2 | ||||||||
| City: | SELLERSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189601575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152571050 | ||||||||
| FaxNumber: | 2152573026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ALTMAN | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2152571050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | MD036191E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 0007719870001 | 05 | PA | MEDICAID |