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General NPI Number Information
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NPI Number | 1477006849
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Entity Type | Organization
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Legal Business Name | FOX CHASE CANCER CENTER
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 333 COTTMAN AVE.
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City | PHILADELPHIA
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State | PA
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Zip | 19111
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Country | US
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Telephone | 215-728-0405
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Fax | 215-728-2761
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Provider Business Mailing Address
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Address Line | 333 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2434
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Country | US
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Telephone | 215-728-0405
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Fax | 215-278-2761
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Authorized Official
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Title or Position | PRECERTIFICATION REPRESENTATIVE
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Name | MS. VALERIE BREWER
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Credential |
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Telephone | 215-728-0405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 231352156
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License Number State | PA
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