Provider Demographics
NPI:1619998507
Name:LIBERTY ONCOLOGY
Entity Type:Organization
Organization Name:LIBERTY ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRESENZO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-539-5373
Mailing Address - Street 1:1 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3105
Mailing Address - Country:US
Mailing Address - Phone:610-539-5373
Mailing Address - Fax:610-539-8260
Practice Address - Street 1:1 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3105
Practice Address - Country:US
Practice Address - Phone:610-539-5373
Practice Address - Fax:610-539-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA074062Medicare ID - Type Unspecified