Healthcare Provider Details

I. General information

NPI: 1104827831
Provider Name (Legal Business Name): CENTER FOR CANCER AND HEMATOLOGIC DISEASE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ROUTE 70 E SUITE V107
CHERRY HILL NJ
08003-2150
US

IV. Provider business mailing address

1930 ROUTE 70 E SUITE V107
CHERRY HILL NJ
08003-2150
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-3311
  • Fax: 856-424-5634
Mailing address:
  • Phone: 856-424-3311
  • Fax: 856-424-5634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD GREENBERG
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 856-424-3311