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NPI Code Detail

MEDICARE: OFELIA A BACANI MD

MEDICARE:   OFELIA A BACANI  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD036604LPA
2207R00000XInternal Medicine PhysicianMD036604LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326032087
Entity Type Code : Individual
Provider Name (Legal Business Name) : OFELIA A BACANI MD
Provider Business Mailing Address
First Line : 350 MACDADE BLVD
Second Line :
City : COLLINGDALE
State : PA
Zip : 19023-1924
Country : US
Telephone Number : 610-586-2599
Fax Number : 610-586-3010
Provider Business Practice Location Address
First Line : 350 MACDADE BLVD
Second Line :
City : COLLINGDALE
State : PA
Zip : 19023-1924
Country : US
Telephone Number : 610-586-2599
Fax Number : 610-586-3010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 03/09/2010

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Directions to “ OFELIA A BACANI MD” Practice Location

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