Provider Demographics
NPI:1841258696
Name:CESCON, TERRENCE P (MD)
Entity type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:P
Last Name:CESCON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 S 5TH AVE
Practice Address - Street 2:BLDG N GROUND READING HOSPITAL REGIONAL CANCER CTR
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-2143
Practice Address - Country:US
Practice Address - Phone:484-628-0900
Practice Address - Fax:484-628-0901
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043684L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA769926OtherBLUE SHIELD
PA0014630610007Medicaid
PA769926OtherMEDICARE PTAN
PA0014630610007Medicaid
F80407Medicare UPIN
830003454Medicare ID - Type UnspecifiedRAILROAD
PA769926OtherBLUE SHIELD
PA0014630610001Medicaid