Provider Demographics
NPI:1538329966
Name:MNAP MEDICAL SOLUTIONS, INC
Entity Type:Organization
Organization Name:MNAP MEDICAL SOLUTIONS, INC
Other - Org Name:MNAP ONCOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-464-3300
Mailing Address - Street 1:9908 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1705
Mailing Address - Country:US
Mailing Address - Phone:215-464-3300
Mailing Address - Fax:215-673-9254
Practice Address - Street 1:9908 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1705
Practice Address - Country:US
Practice Address - Phone:215-464-3300
Practice Address - Fax:215-673-9254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAC20-486932085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00056781OtherPALMETTO MEDICARE ID- TYPE UNSPECIFIED
PA3Y3460OtherHEALTH NET
PA1646499OtherHIGHMARK BLUE SHIELD
PA3266178OtherAETNA
PA1019492480001Medicaid
PA9269OtherBRAVO/ELDER HEALTH
PA2324240000OtherKHPE
PA2324240000OtherIBC
PA2347186OtherUNITED HEALTHCARE
PA33677OtherHEALTH PARTNERS
PA30008154OtherKEYSTONE MERCY
PA3Y3460OtherHEALTH NET