1639341860 NPI number — ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.

Table of content: (NPI 1639341860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639341860 NPI number — ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.
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:
ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.
Provider Other Organization Name Type Code:
3
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:
1639341860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 MEDICAL CENTER BLVD
Provider Second Line Business Mailing Address:
SUITE 341
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013-3902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-619-7430
Provider Business Mailing Address Fax Number:
610-876-6923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 BYPASS RD STE 204
Provider Second Line Business Practice Location Address:
MANNINGTON MEDICAL PLAZA
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08079-2053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-619-7430
Provider Business Practice Location Address Fax Number:
610-876-6923
Provider Enumeration Date:
03/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
VIVACQUA
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-619-7420

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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