Blackstone, Burt Ross

Blackstone, Burt Ross is an individual health care provider with primary practice located at 1201 Langhorne Newtown Road St Mary Medical Center, Langhorne PA 19047. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Blackstone, Burt Ross can be contacted via phone (215) 710-5900.

Contact Information

Primary practice address
1201 Langhorne Newtown Road St Mary Medical Center Langhorne PA 19047
Phone: (215) 710-5900
Fax: (215) 710-6973
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X OS006397E Pennsylvania

Profile Details

NPI number 1851358246
LBN Legal business name Blackstone, Burt Ross
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated May 21st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851358246 NPPES
Pennsylvania MEDICAID 0011712810011

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