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General NPI Number Information
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NPI Number | 1891771044
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER BLVD STE 341 CROZER REGIONAL CANCER CENTER
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City | UPLAND
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State | PA
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Zip | 19013-3902
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Country | US
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Telephone | 610-619-7420
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Fax | 610-876-6923
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER BLVD STE 341 CROZER REGIONAL CANCER CENTER
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City | UPLAND
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State | PA
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Zip | 19013-3902
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Country | US
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Telephone | 610-619-7420
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Fax | 610-876-6923
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND J VIVACQUA
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Credential | M.D.
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Telephone | 610-619-7420
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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 |
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License Number State |
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