MEDICARE: DR. BENJAMIN FRANK COCCHIARO M.D., M.P.H.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	MD465329	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336529890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN FRANK COCCHIARO M.D., M.P.H.

Provider Business Mailing Address
First Line	:	2225 MARTHA ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-2025
Country	:	US
Telephone Number	:	215-285-2321
Fax Number	:

Provider Business Practice Location Address
First Line	:	2913 KENSINGTON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-3016
Country	:	US
Telephone Number	:	215-285-2321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2015
Last Update Date	:	01/07/2020

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