MEDICARE: DR. MARK J CORNFELD 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
1	207RX0202X	Medical Oncology Physician	MD033235E	PA

General Provider Information

NPI Number	:	1619234408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK J CORNFELD MD

Provider Business Mailing Address
First Line	:	227 S 6TH ST APT PC
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3724
Country	:	US
Telephone Number	:	609-240-7312
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 S 6TH ST APT PC
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3724
Country	:	US
Telephone Number	:	609-240-7312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	12/27/2022

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