Provider Demographics
NPI:1891771044
Name:ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.
Entity Type:Organization
Organization Name:ASSOCIATES IN HEMATOLOGY-ONCOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:VIVACQUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-619-7420
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 341 CROZER REGIONAL CANCER CENTER
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-619-7420
Mailing Address - Fax:610-876-6923
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:STE 341 CROZER REGIONAL CANCER CENTER
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-619-7420
Practice Address - Fax:610-876-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ071060Medicare PIN
PA412164Medicare PIN
PA1009510001Medicare NSC