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General NPI Number Information
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NPI Number | 1619062668
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HEALTH CARE ASSOCIATES
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 34TH & CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-590-1000
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Fax | 215-977-8864
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Provider Business Mailing Address
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Address Line | 100 N 20TH ST STE 301 CHCA
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1454
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Country | US
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Telephone | 215-567-2422
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Fax | 215-561-0959
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Authorized Official
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Title or Position | FINANCE OFFICER
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Name | MICHAEL CORBO
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Credential |
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Telephone | 215-567-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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