Blake C Corcoran (NPI# 1235490038, PAC ID# 8729222393) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is SPORTS MEDICINE.
Nation Provider ID (NPI) | 1235490038 |
PAC ID by PECOS | 8729222393 |
Professional Enrollment ID | I20160914001026 |
Full Name | Blake C Corcoran |
Organization Legal Name | DREXEL UNIVERSITY |
Address |
10 Shurs Ln Philadelphia PA 19127-2123 |
Phone Number | 2154821234 |
Gender | M |
Medical School | UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE |
Graduation Year | 2012 |
Primary Specialty | SPORTS MEDICINE |
Secondary Specialties | FAMILY PRACTICE |
Group Practice PAC ID | 5496664740 |
Number of Group Practice Members | 235 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
390290 | HAHNEMANN UNIVERSITY HOSPITAL |
390304 | ROXBOROUGH MEMORIAL HOSPITAL |
Address | Phone | Organization |
---|---|---|
10 Shurs Ln, Philadelphia, PA 19127-2123 | 2154821234 | DREXEL UNIVERSITY |
Organization Legal Name | DREXEL UNIVERSITY |
Physicians | 217 |
Name | Specialty | Organization | Address |
---|---|---|---|
Maanit Kohli | Internal Medicine | Drexel University | 255 S 17th St 3rd Floor, Drexel Internal Medicine, Philadelphia, PA 19103-6231 |
Aisha N Qazi | Neurology | Drexel University | 219 N Broad St 7th Floor, Drexel Neurology, Philadelphia, PA 19107-1506 |
Ashley Lynne Parker | Obstetrics/gynecology | Drexel University | 216 N Broad St 1st Floor, Philadelphia, PA 19102-1121 |
Michael J Mccormack | Hematology/oncology | Drexel University | 230 N Broad St 15th Floor, Drexel Hematology Oncology, Philadelphia, PA 19102-1121 |
Kristen M Ryczak | Family Medicine | Drexel University | 3401 Market St, 105a, Philadelphia, PA 19104-3315 |
Azzam Hammad | Pathology | Drexel University | 245 N 15th St, Drexel Pathology, Philadelphia, PA 19102-1101 |
Kenneth C Lau | Internal Medicine | Drexel University | 2126 Fairmount Ave, Philadelphia, PA 19130-2603 |
Amanda Z De La Paz | Geriatric Medicine | Drexel University | 10 Shurs Ln, Philadelphia, PA 19127-2123 |
Amy S Baranoski | Infectious Disease | Drexel University | 219 N Broad St 5th Floor, Drexel Infectious Disease, Philadelphia, PA 19107-1507 |
Srikala S Ponnuru | Emergency Medicine | Drexel University | 230 N Broad St 7th Floor, Drexel Infectious Disease, Philadelphia, PA 19102-1121 |
Street Address |
10 SHURS LN |
City | PHILADELPHIA |
State | PA |
Zip | 19127-2123 |
Name | Specialty | Organization | Address |
---|---|---|---|
Amanda Z De La Paz | Geriatric Medicine | Drexel University | 10 Shurs Ln, Philadelphia, PA 19127-2123 |
City | PHILADELPHIA |
Zip Code | 19127 |
Specialty | SPORTS MEDICINE |
City + Specialty | PHILADELPHIA + SPORTS MEDICINE |
Please comment or provide details below to improve the information on Blake C Corcoran.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.