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Organization
FOX CHASE CANCER CENTER MEDICAL GROUP, INC
Active
Organization
FOX CHASE CANCER CENTER MEDICAL GROUP, INC
Active
Other names
Pain Mana 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) 728-3544
(215) 214-3901
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-3544
(215) 728-2887
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
03/06/2012
Last updated
06/14/2018
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