1265601058 NPI number — CENTER FOR CANCER AND HEMATOLOGIC DISEASE PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265601058 NPI number — CENTER FOR CANCER AND HEMATOLOGIC DISEASE PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR CANCER AND HEMATOLOGIC DISEASE PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265601058
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1930 EAST ROUTE 70
Provider Second Line Business Mailing Address:
SUITE V107
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-424-3311
Provider Business Mailing Address Fax Number:
856-489-0888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
239 HUFFVILLE-CROSS KEYS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEWELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-404-9719
Provider Business Practice Location Address Fax Number:
856-489-0888
Provider Enumeration Date:
02/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SIEGEL
Authorized Official First Name:
NORMAN
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
854-424-3311

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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