BRIAN EDWARD LALLY (NPI# 1114102407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114102407 |
| Entity Type | Individual |
| Full Name | BRIAN EDWARD LALLY |
| Credential | MD |
| Practice Address |
3400 Civic Center Blvd Philadelphia PA 19104-5127 |
| Practice Telephone | 2156624853 |
| Mailing Telephone | 2156624853 |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2016-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD423422 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
3400 CIVIC CENTER BLVD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027727 | Joel D Glickman | Internal Medicine | 3400 Civic Center Blvd, 1st Floor, Suite 300 S, Philadelphia, PA 19104-4306 | 2005-07-18 |
| 1841891058 | Abigail Brooke Horowitz | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-11-04 |
| 1073129532 | Samuel Kovell | Physician Assistant | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-21 |
| 1306451695 | Farzad Nourollah-zadeh | Oral Medicinist | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-09-13 |
| 1609492917 | Mosetta Harris | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-06-23 |
| 1063032530 | Monique Maria Tee | Internal Medicine | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-24 |
| 1609495290 | Katharine Freeman Michel | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104 | 2020-04-13 |
| 1609495498 | Taha Samir Ghouleh | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-11 |
| 1952930554 | Danielle Marie Lamarra | Nurse Practitioner | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-06 |
| 1982232658 | Jasmine Hwang | Student in an Organized Health Care Education/Training Program | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912433632 | Victor Eric Chen | Radiology | 111 S 11th St # G301, Philadelphia, PA 19107 | 2017-05-02 |
| 1346635455 | Adam Christopher Mueller | Radiology | 111 S 11th St Ste G-301, Philadelphia, PA 19107-4824 | 2015-04-06 |
| 1487916193 | Sonam Sharma | Radiology | 3400 Civic Blvd, Philadelphia, PA 19104-4206 | 2012-06-10 |
| 1245439017 | Edward M Marchan | Radiology | 909 Walnut St Fl 3, Department of Neurosurgery Thomas Jefferson Univ, Philadelphia, PA 19107-5211 | 2007-07-12 |
| 1710052212 | Thomas J Galloway | Radiology | 333 Coltman Avenue, Fox Chase Cancer Center, Philadelphia, PA 19111 | 2006-11-21 |
| 1811910854 | William T Grizos | Radiology | 8835 Germantown Ave., Philadelphia, PA 19118-2718 | 2006-07-25 |
| 1972525400 | Shari Rudoler | Radiology | Knights & Red Lion Roads, Philadelphia, PA 19114 | 2006-07-24 |
| 1730135393 | Voichita Bar Ad | Radiology | 111 S. 11th Street, Bodine Center Jefferson Radiation Oncology Associates, Philadelphia, PA 19107 | 2006-05-25 |
| 1467403121 | Patrick M Tripp | Radiology | 3400 Civic Center, Pcam - Radiation Oncology Trc 2 West, Philadelphia, PA 19104 | 2006-05-15 |
| 1548249287 | William R Rate | Radiology | 3400 Civic Center Blvd., Concourse Level, Philadelphia, PA 19104-4306 | 2006-01-11 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.