Provider Demographics
NPI:1174704886
Name:LEE H. KOSTER, M. D.,P.C.
Entity type:Organization
Organization Name:LEE H. KOSTER, M. D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:H
Authorized Official - Last Name:KOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-339-8600
Mailing Address - Street 1:634 FOURTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6505
Mailing Address - Country:US
Mailing Address - Phone:724-339-8600
Mailing Address - Fax:724-339-0520
Practice Address - Street 1:634 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6505
Practice Address - Country:US
Practice Address - Phone:724-339-8600
Practice Address - Fax:724-339-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014294E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA069315Medicare PIN
PAB34074Medicare UPIN