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Organization
FOX CHASE CANCER CENTER MEDICAL GROUP, INC
Active
Organization
FOX CHASE CANCER CENTER MEDICAL GROUP, INC
Active
Other names
PATH Assoc of FCCC, MGI
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA WOODARD (CREDENTIALING/MANAGER)
(215) 707-3911
Entity
Organization
Contact information
Practice address
333 COTTMAN AVE, FOX CHASE CANCER CENTER, PHILADELPHIA, PA 19111-2434
(215) 728-3675
(215) 214-3901
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-3675
(215) 728-2848
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
NULL
207ZC0500X
Cytopathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
NULL
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
03/06/2012
Last updated
06/14/2018
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