Provider Demographics
NPI:1295853471
Name:HEALTH ACCESS NETWORK
Entity Type:Organization
Organization Name:HEALTH ACCESS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-338-8386
Mailing Address - Street 1:PO BOX 8500-6355
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:610-497-7520
Mailing Address - Fax:610-497-7525
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1129
Practice Address - Country:US
Practice Address - Phone:610-626-7070
Practice Address - Fax:610-626-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA356691OtherPA BLUE SHIELD GROUP