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General NPI Number Information
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NPI Number | 1942368196
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Entity Type | Organization
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Legal Business Name | J FREDERICK LAUCIUS MD LEWIS J ROSE MD ANDREW E CHAPMAN DO ET AL
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 1015 CHESTNUT ST SUITE 1321
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4316
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Country | US
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Telephone | 215-238-1139
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 CHESTNUT ST SUITE 306
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4316
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Country | US
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Telephone | 215-238-1139
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Fax | 215-574-1492
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. DIANE DALESSIO
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Credential |
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Telephone | 215-238-1139
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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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