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General NPI Number Information
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NPI Number | 1336529890
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Entity Type | Individual
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Provider Name | BENJAMIN FRANK COCCHIARO M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2015
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 2913 KENSINGTON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-3016
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Country | US
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Telephone | 215-285-2321
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 MARTHA ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-2025
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Country | US
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Telephone | 215-285-2321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD465329
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License Number State | PA
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