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Organization

FOX CHASE CANCER CENTER MEDICAL GROUP, INC

Active
Other names
Med Onc 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) 728-2500
(215) 728-3639
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-2500
(215) 728-3639

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1026888280017
PA
05
1026888280031
PA
05
1026888280034
PA
Enumeration date
03/07/2012
Last updated
06/14/2018
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