Provider Demographics
NPI:1588674469
Name:RADIATION ONCOLOGY CONSULTANTS OF PENNSYLVANIA, PC
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY CONSULTANTS OF PENNSYLVANIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-821-5563
Mailing Address - Street 1:3674 ROUTE 27, RADIATION ONCOLOGY CONSULTANTS OF PA, PC
Mailing Address - Street 2:DEPARTMENT B
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824
Mailing Address - Country:US
Mailing Address - Phone:732-821-5563
Mailing Address - Fax:732-821-6675
Practice Address - Street 1:1201 LANGHORNE NEWTOWN RD
Practice Address - Street 2:RADIATION ONCOLOGY CONSULTANTS OF PENNSYLVANIA, PC
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1201
Practice Address - Country:US
Practice Address - Phone:215-710-5300
Practice Address - Fax:215-710-6781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA093970Medicare PIN