Healthcare Provider Details

I. General information

NPI: 1548408123
Provider Name (Legal Business Name): HEALTH ACCESS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
CHESTER PA
19013-3902
US

IV. Provider business mailing address

1 MEDICAL CENTER BLVD
CHESTER PA
19013-3902
US

V. Phone/Fax

Practice location:
  • Phone: 610-619-7410
  • Fax: 610-490-0925
Mailing address:
  • Phone: 610-619-7410
  • Fax: 610-490-0925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD013629E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberMD053000L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License NumberMD023651E
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD044563L
License Number StatePA

VIII. Authorized Official

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