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General NPI Number Information
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NPI Number | 1356302178
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Entity Type | Organization
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Legal Business Name | BERKS HEMATOLOGY ONCOLOGY ASSOC LTD
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | S 6TH AVE & SPRUCE ST TRHMC REGIONAL CANCER CENTER N-GROUND
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City | WEST READING
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State | PA
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Zip | 19611
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Country | US
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Telephone | 610-374-4404
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Fax | 610-374-1396
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Provider Business Mailing Address
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Address Line | PO BOX 16052
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City | READING
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State | PA
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Zip | 19612-6052
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Country | US
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Telephone | 610-374-4404
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Fax | 610-374-1396
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NICK C. LEASURE
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Credential | M.D.
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Telephone | 610-374-4404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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