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General NPI Number Information
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NPI Number | 1417927187
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Entity Type | Organization
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Legal Business Name | FORNANCE PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 1330 POWELL ST SUITE 308
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City | NORRISTOWN
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State | PA
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Zip | 19401-3353
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Country | US
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Telephone | 610-270-2192
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Fax | 610-270-2364
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Provider Business Mailing Address
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Address Line | PO BOX 820137
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City | PHILADELPHIA
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State | PA
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Zip | 19182-0137
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Country | US
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Telephone | 610-270-2352
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Fax | 610-270-2358
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Authorized Official
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Title or Position | DIRECTOR PHYSICIAN BILLING
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Name | VERA BURNETT-ROBINS
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Credential |
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Telephone | 484-622-7391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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