| Fox Chase Cancer Center Medical Group, Inc | |
|
333 Cottman Ave Fox Chase Cancer Center Philadelphia PA 19111-2434 | |
| (215) 728-6900 | |
| (215) 214-3901 |
| Full Name | Fox Chase Cancer Center Medical Group, Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 333 Cottman Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Tonya Woodard (CREDENTIALING/MANAGER) |
| Authorized Official Contact | 2157073911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox Chase Cancer Center Medical Group, Inc 2450 W Hunting Park Ave Philadelphia PA 19129-1302 Ph: (215) 728-6900 | Fox Chase Cancer Center Medical Group, Inc 333 Cottman Ave Fox Chase Cancer Center Philadelphia PA 19111-2434 Ph: (215) 728-6900 |
| NPI Number | 1710251897 |
|---|---|
| Provider Enumeration Date | 03/07/2012 |
| Last Update Date | 06/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710251897 | NPI | - | NPPES |
| 1026888280002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Pennsylvania) | Primary |
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