Provider Demographics
NPI:1023192606
Name:RONALD I CANTOR & WILLAIM BIERMANN MD PC
Entity Type:Organization
Organization Name:RONALD I CANTOR & WILLAIM BIERMANN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-955-6039
Mailing Address - Street 1:834 WALNUT ST
Mailing Address - Street 2:STE 110
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-955-6039
Mailing Address - Fax:215-955-5155
Practice Address - Street 1:834 WALNUT ST
Practice Address - Street 2:STE 110
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-955-6039
Practice Address - Fax:215-955-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA148658OtherRAILROAD MEDICARE
PA0061453000OtherINDEPENDENCE BLUE CROSS
PA52134OtherAETNA
PA52134OtherAETNA