FOX CHASE CANCER CENTER MEDICAL GROUP, INC (NPI# 1881968063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881968063 |
| Entity Type | Organization |
| Organization Name | FOX CHASE CANCER CENTER MEDICAL GROUP, INC |
| Other Organization Name | GYNONC ASSOC OF FCCC, MGI |
| Practice Address |
333 Cottman Ave Philadelphia PA 19111-2434 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157286900 |
| Practice Fax Number | 2157283639 |
| Mailing Telephone | 2157286900 |
| Mailing Fax Number | 2157283639 |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2018-06-14 |
| Authorized Official Name | TONYA WOODARD (CREDENTIALING/MANAGER) |
| Authorized Official Telephone | 2157073911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1026888280011 | 05 | |
| PA | 1026888280030 | 05 | |
| PA | 1026888280038 | 05 |
| Other Name | Type Code |
|---|---|
| GynOnc Assoc of FCCC, MGI | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2365 Heritage Center Dr, Furlong, PA 189251280 | 2157286900 | 2157283639 |
| 2701 Dekalb Pike, Norristown, PA 194011820 | 8883692587 | 2157283639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801160981 | Fox Chase Cancer Center Medical Group, Inc | Psychologist | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1710251897 | Fox Chase Cancer Center Medical Group, Inc | Psychiatry & Neurology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1073887154 | Fox Chase Cancer Center Medical Group, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1518231695 | Fox Chase Cancer Center Medical Group, Inc | Surgery | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1457625535 | Fox Chase Cancer Center Medical Group, Inc | Otolaryngology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1538433610 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, West Bldg/cru, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1528332608 | Fox Chase Cancer Center Medical Group, Inc | Radiology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1427322502 | Fox Chase Cancer Center Medical Group, Inc | Urology | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1992079073 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2012-03-07 |
| 1447524525 | Fox Chase Cancer Center Medical Group, Inc | Internal Medicine | 333 Cottman Ave, Fox Chase Cancer Center, Philadelphia, PA 19111-2434 | 2012-03-07 |
| Street Address |
333 COTTMAN AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19111-2434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356347504 | Sangeeta K Tyerech | Radiology | 333 Cottman Ave, Philadelphia, PA 19111 | 2005-06-22 |
| 1114524097 | Bernadette Golarz | Nurse Anesthetist, Certified Registered | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-10-05 |
| 1023625878 | Nallely Hernandez | Internal Medicine | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2020-09-25 |
| 1780298612 | Jean Marie Arlt | Psychologist | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-09-08 |
| 1811500549 | Facundo Iriarte | Surgery | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2020-08-24 |
| 1275157455 | Temple University Hospital, Inc | General Acute Care Hospital | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-06-03 |
| 1548898836 | Hannah Rosenstein Campbell | Genetic Counselor, MS | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2020-03-31 |
| 1285281238 | Senthuran Tharmalingam | Surgery | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2019-08-23 |
| 1619452885 | Max David Lefton | Surgery | 333 Cottman Ave, Philadelphia, PA 19111-2434 | 2018-10-03 |
| 1730669425 | Christopher Mkl Yao | Otolaryngology | 333 Cottman Ave, Philadelphia, PA 19111-2497 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036026 | Grace Agency Incorporated | Home Health | 433 Longshore Ave, Philadelphia, PA 19111 | 2020-09-08 |
| 1124517750 | Dana Christine Campetti | Physician Assistant | 700 Cottman Ave Ste 201, Philadelphia, PA 19111 | 2018-05-09 |
| 1235654286 | Dorotea Mutabdzic | Surgery | Fox Chase Cancer Center, 333 Cottman Ave, Dept of Surgical Oncology, Philadelphia, PA 19111 | 2017-08-11 |
| 1952841041 | Personal Care Home C&g | Point of Service | 6176 Newtown Ave, Philadelphia, PA 19111 | 2017-03-08 |
| 1477006849 | Fox Chase Cancer Center | Clinic/Center | 333 Cottman Ave., Philadelphia, PA 19111 | 2016-08-02 |
| 1578927521 | Peter Whooley | Student in an Organized Health Care Education/Training Program | Temple University/fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111 | 2016-04-06 |
| 1043673783 | Matthew Holzerman | Physical Therapy Assistant | 1148 Tabor Plz, Philadelphia, PA 19111 | 2016-03-31 |
| 1831563329 | Aging With Care Inc | Home Health | 1614 Loney St, Philadelphia, PA 19111 | 2015-11-20 |
| 1043687551 | Kenneth Marsaglia II | Preventive Medicine | 8414 Bridle Road, Philadelphia, PA 19111 | 2015-09-01 |
| 1700220514 | Lorraine A Tauriello | Counselor | 716 Ripley St, Philadelphia, PA 19111 | 2013-04-23 |
| Find all providers in zip 19111 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750618385 | Robert L Giuntoli | Obstetrics & Gynecology | 4537 Pine St, Philadelphia, PA 19143-1805 | 2009-11-03 |
| 1356496038 | Philadelphia Health & Education Corporation | Obstetrics & Gynecology | 246 North Broad St, 15th Floor South Tower, Philadelphia, PA 19102 | 2007-01-24 |
| 1356348056 | Charles Edmund Mangan Sr. | Obstetrics & Gynecology | 233 S 6th St Apt 2406, 233 S 6th St, Philadelphia, PA 19106-3757 | 2005-07-07 |
| 1063995710 | Temple Faculty Practice Plan, Inc | Obstetrics & Gynecology | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-10 |
| 1235527342 | University of Penn-medical Group | Obstetrics & Gynecology | 3400 Civic Center Blvd, 3rd Floor, Philadelphia, PA 19104-5127 | 2014-12-26 |
| 1568873156 | Margaret Elizabeth Whicker | Obstetrics & Gynecology | 3400 Civic Center Blvd, Philadelphia, PA 19104 | 2014-05-16 |
| 1366734550 | Erin Margaret George | Obstetrics & Gynecology | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2011-05-06 |
| 1770873085 | Lori Amanda Cory | Obstetrics & Gynecology | 3400 Civic Center Blvd, Philadelphia, PA 19104 | 2011-04-08 |
| 1023247335 | Nawar D Abdul Latif | Obstetrics & Gynecology | 3400 Civic Center Blvd, 3rd Floor West, Philadelphia, PA 19104-5127 | 2009-07-08 |
| 1649433319 | Janos L Tanyi | Obstetrics & Gynecology | 3400 Civic Center Boulevard, 3rd Floor, Philadelphia, PA 19104-4206 | 2008-07-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19111 |
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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.