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FOX CHASE CANCER CENTER MEDICAL GROUP INC NPI 1073887154


NPI Information

NPI: 1073887154
Provider Name: FOX CHASE CANCER CENTER MEDICAL GROUP, INC

Doing Business As: THOR SURG ASSOC OF FCCC, MGI

Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
333 COTTMAN AVE
FOX CHASE CANCER CENTER
PHILADELPHIA, PA
ZIP 19111
Phone: (215) 728-6900
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FOX CHASE CANCER CENTER MEDICAL GROUP, INC is a thoracic surgery cardiothoracic vascular surgery in Philadelphia, PA. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. FOX CHASE CANCER CENTER MEDICAL GROUP, INC NPI is 1073887154. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Thor Surg Assoc Of Fccc, Mgi.

The provider's business location address is:

333 COTTMAN AVE
FOX CHASE CANCER CENTER
PHILADELPHIA, PA
ZIP 19111
Phone: (215) 728-6900
Fax: (215) 728-2773

The provider's authorized official is Tonya Woodard .
The authorized official title is Credentialing/manager and has the following contact phone number (215) 707-3911.

The enumeration date for this NPI number is 3/7/2012 and was last updated on 6/14/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11026888280035MEDICAIDPENNSYLVANIA
21026888280025MEDICAIDPENNSYLVANIA
31026888280006MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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