Organization
J FREDERICK LAUCIUS MD LEWIS J ROSE MD ANDREW E CHAPMAN DO ET AL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE DALESSIO (BILLING MANAGER)
(215) 238-1139
Entity
Organization
Contact information
Practice address
1015 CHESTNUT ST, SUITE 1321, PHILADELPHIA, PA 19107-4316
(215) 238-1139
Mailing address
1015 CHESTNUT ST, SUITE 306, PHILADELPHIA, PA 19107-4316
(215) 238-1139
(215) 574-1492
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026192
HIGHMARK BLUE SHIELD
—
01
—
0061424000
KEYSTONE PC
—
Enumeration date
12/04/2006
Last updated
08/05/2008
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