Provider Demographics
NPI:1336414226
Name:CHOP CLINICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:CHOP CLINICAL ASSOCIATES, PC
Other - Org Name:CARE NETWORK GIBBSBORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-590-5317
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 LAKEVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1155
Practice Address - Country:US
Practice Address - Phone:856-783-2802
Practice Address - Fax:856-783-2806
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE NETWORK GIBBSBORO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-12
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty