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General NPI Number Information
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NPI Number | 1720454564
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Entity Type | Organization
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Legal Business Name | COMMUNITY CANCER CENTERS OF AMERICA LLC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 691 STATE HIGHWAY 33
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City | TRENTON
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 201-215-5535
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Fax | 844-241-7242
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Provider Business Mailing Address
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Address Line | 691 STATE HIGHWAY 33
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City | TRENTON
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 201-215-5535
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Fax | 844-241-7242
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. PANKAJ K AKSHAY
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Credential |
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Telephone | 201-215-5535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MA38585
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License Number State | NJ
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