Organization
FOX CHASE CANCER CENTER MEDICAL GROUP, INC
Active
Other names
Psychology Assoc of FCCC, MGI
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SQUADRONI (CREDENTIALING ANALYST)
(215) 707-3411
Entity
Organization
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2497
(215) 214-3940
(215) 214-1425
Mailing address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2497
(215) 214-3940
(215) 214-1425
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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