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NPI Code Detail

MEDICARE: ALICIA BAO

MEDICARE: ALICIA BAO
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
1207RH0003XHematology & Oncology PhysicianMT229321PA

General Provider Information

NPI Number : 1922793660
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA BAO
Provider Business Mailing Address
First Line : 3401 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5189
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 833 CHESTNUT ST STE 220
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4405
Country : US
Telephone Number : 215-955-8465
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2023
Last Update Date : 05/20/2026

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Directions to “ ALICIA BAO ” Practice Location

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