MEDICARE: FOX CHASE MEDICAL ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0201090000	OTHER	PA	BLUE SHIELD & KEYSTONE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174593123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOX CHASE MEDICAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	7500 CENTRAL AVENUE
Second Line	:	SUITE 104
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2431
Country	:	US
Telephone Number	:	215-742-0712
Fax Number	:	215-742-5218

Provider Business Practice Location Address
First Line	:	7500 CENTRAL AVENUE
Second Line	:	SUITE 104
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2431
Country	:	US
Telephone Number	:	215-742-0712
Fax Number	:	215-742-5218

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. HOWARD D BRONSTEIN
Credential	:	MD
Telephone Number	:	215-742-0712

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	08/05/2010

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Directions to “FOX CHASE MEDICAL ASSOCIATES PC ” Practice Location

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