FOX CHASE CANCER CENTER MEDICAL GROUP, INC (NPI# 1518231695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518231695 |
| Entity Type | Organization |
| Organization Name | FOX CHASE CANCER CENTER MEDICAL GROUP, INC |
| Other Organization Name | GEN SURG ASSOC OF FCCC, MGI |
| Practice Address |
333 Cottman Ave Fox Chase Cancer Center Philadelphia PA 19111-2434 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157286900 |
| Mailing Telephone | 2157286900 |
| Mailing Fax Number | 2157282773 |
| Enumeration Date | 2012-03-07 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1026888280033 | 05 | |
| PA | 1026888280005 | 05 | |
| PA | 1026888280027 | 05 |
| Other Name | Type Code |
|---|---|
| Gen Surg Assoc of FCCC, MGI | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2365 Heritage Center Dr, Furlong, PA 189251280 | 2157286900 | 2157282773 |
| 2701 Dekalb Pike, Norristown, PA 194011820 | 8883692487 | 2157282773 |
| 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 |
| 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 |
| 1891069977 | 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 FOX CHASE CANCER CENTER |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1962993170 | Brian M Till | Surgery | 1015 Walnut Street, Suite 620 Curtis, Philadelphia, PA 19107-5005 | 2018-05-23 |
| 1356838932 | Walker Lyons | Surgery | 1015 Walnut St Ste 210, Philadelphia, PA 19107-5005 | 2018-04-18 |
| 1790213114 | Matthew Paul Mullarkey | Surgery | 3401 N Broad St Ste C405, Philadelphia, PA 19140-5103 | 2017-05-30 |
| 1528424090 | Zhen Lu | Surgery | 5401 Old York Rd # Klein101, Philadelphia, PA 19141-3030 | 2016-01-13 |
| 1235517996 | David Kim | Surgery | 3401 N Broad St # 3ppc388, Philadelphia, PA 19140 | 2015-05-14 |
| 1578941282 | Amanda Elizabeth Deliere | Surgery | 3400 N Broad St, Philadelphia, PA 19140-5104 | 2015-05-13 |
| 1649660804 | Deviney Rattigan | Surgery | 1110 Lombard St Apt 24, Philadelphia, PA 19147-1206 | 2015-01-27 |
| 1346676988 | Aviva Wallace Kaplin | Surgery | 20 E Abington Ave, Philadelphia, PA 19118-3410 | 2013-09-15 |
| 1619300571 | Roshin Thomas | Surgery | 8815 Germantown Ave Fl 2, Philadelphia, PA 19118-2722 | 2013-08-14 |
| 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.