Healthcare Provider Details

I. General information

NPI: 1568757623
Provider Name (Legal Business Name): HEALTH ACCESS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD POB # 1 SUITE 200
CHESTER PA
19013-3902
US

IV. Provider business mailing address

2602 W 9TH ST
CHESTER PA
19013-2040
US

V. Phone/Fax

Practice location:
  • Phone: 610-619-8420
  • Fax: 610-619-8421
Mailing address:
  • Phone: 610-497-7407
  • Fax: 610-497-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD058852L
License Number StatePA

VIII. Authorized Official

Name: MR. JAMES STUCCIO
Title or Position: PRESIDENT
Credential:
Phone: 610-338-8386