Organization
HEALTH SERVICES OF FCCC
Active
Other names
Anesthesia Assoc of FCCC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GREEN (CREDENTIALING MANAGER)
(215) 728-2697
Entity
Organization
Contact information
Practice address
333 COTTMAN AVENUE, FOX CHASE CANCER CENTER, PHILADELPHIA, PA 19111
(215) 728-6900
Mailing address
333 COTTMAN AVENUE, MEDICAL STAFF OFFICE, PHILADELPHIA, PA 19111
(215) 728-6900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007736990006
—
PA
Enumeration date
03/08/2006
Last updated
11/15/2011
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