Organization
UNIVERSITY OF PENN-MERCER RAD ONC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
446 BELLEVUE AVE, TRENTON, NJ 08618-4502
(609) 394-4243
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0261867000
AMERIHEALTH
NJ
01
—
2Y21678
HEALTHNET
NJ
01
—
467129
BLUE SHIELD
NJ
01
—
494494
AETNA
NJ
05
—
5331706
—
NJ
Enumeration date
08/29/2006
Last updated
01/06/2014
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