Provider Demographics
NPI:1992791156
Name:BUCKS-MONT DERMATOLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:BUCKS-MONT DERMATOLOGY ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-345-4080
Mailing Address - Street 1:103 PROGRESS DR
Mailing Address - Street 2:STE 100
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2511
Mailing Address - Country:US
Mailing Address - Phone:215-345-4080
Mailing Address - Fax:215-345-7575
Practice Address - Street 1:103 PROGRESS DR
Practice Address - Street 2:STE 100
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2511
Practice Address - Country:US
Practice Address - Phone:215-345-4080
Practice Address - Fax:215-345-7575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003398L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5256722OtherAETNA
733753OtherIBC
PA001828046Medicaid
PA043028Medicare PIN
5256722OtherAETNA