Basic Information
| Provider Information | |||||||||
| NPI: | 1467699744 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOWER BUCKS PHYSICIAN ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 W. GILBERT STREET | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | RED BANK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322120051 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 BATH RD | ||||||||
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| City: | BRISTOL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190073101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157859200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2009 | ||||||||
| LastUpdateDate: | 04/12/2018 | ||||||||
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| AuthorizedOfficialLastName: | CALABRO | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7322120060 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207ZP0102X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 2095211 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 30059864 | 01 | PA | KEYSTONE MERCY | OTHER | DO9584 | 01 | PA | RAILROAD MEDICARE | OTHER | 2101121 | 01 | PA | HIGHMARK BLUE SHIELD (CRNA #) | OTHER | 3702658000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 102247510 0001 | 05 | PA | MEDICAID |