Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Other names
Temple Pediatric Hematology Oncology Assoc
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY CLARK (DIRECTOR, GOVERNMENT AND PAYER RELA)
(215) 707-4739
Entity
Organization
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-6613
(215) 707-6629
Mailing address
3425 N CARLISLE ST, 2ND FL HUDSON BUILDING, PHILADELPHIA, PA 19140-5108
(215) 707-3911
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007780130698
—
PA
Enumeration date
03/07/2007
Last updated
08/22/2020
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