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PLASTIC/RECON ASSOC OF FCCC, MGI
NPI 1083988166
Surgery - Plastic and Reconstructive Surgery in Philadelphia, PA

Active since March 07, 2012
333 COTTMAN AVE, FOX CHASE CANCER CENTER, PHILADELPHIA, PA 19111(215) 728-6900(215) 728-5507 Get Directions Write a Review

NPPES record last updated: June 14, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Plastic/recon Assoc Of Fccc, Mgi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLASTIC/RECON ASSOC OF FCCC, MGI (NPI 1083988166) is a healthcare organization registered as a plastic and reconstructive surgery in Philadelphia, Pennsylvania and active in the NPI registry since March 2012. The organization maintains 2 additional practice locations and lists Tonya Woodard, Credentialing/manager, as its authorized official.

NPPES Registry Identity

NPI1083988166
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameFOX CHASE CANCER CENTER MEDICAL GROUP, INC
Location Address333 COTTMAN AVE, FOX CHASE CANCER CENTERPhiladelphia, PA 19111
Mailing Address2450 W Hunting Park AvePhiladelphia, PA 19129-1302 · (215) 728-6900 · Fax (215) 728-5507
Phone(215) 728-6900
Fax(215) 728-5507
Organization SubpartNo
Authorized OfficialTonya WoodardCredentialing/manager · (215) 707-3911
Enumeration DateMarch 7, 2012
Last NPPES UpdateJune 14, 2018
✔ NPI 1083988166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition
A surgeon who specializes in plastic and reconstructive surgery.
Also ListedPlastic SurgeryTaxonomy 208200000X
333 COTTMAN AVE, Philadelphia, PA 19111
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Other Names 1

Doing Business AsPlastic/recon Assoc Of Fccc, Mgi

Secondary Practice Locations 2

Location 12365 Heritage Center DrFurlong, PA 18925-1280 · Phone (215) 782-6900 · Fax (215) 728-5507
Location 22701 Dekalb PikeNorristown, PA 19401-1820 · Phone (888) 369-2487 · Fax (215) 728-5507

Other Identifiers 3

Medicaid1026888280029PA
Medicaid1026888280037PA
Medicaid1026888280019PA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOX CHASE CANCER CENTER MEDICAL GROUP, INC.
Anesthesiology
333 COTTMAN AVE, MED STAFF OFFICE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
JAMES SUN MD
Surgery (Surgical Oncology)
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 854-9799
MS. MALA T KAILASAM MD
Internal Medicine
333 COTTMAN AVE, FOX CHASE CANCER CENTER
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
HEALTH SERVICES OF FOX CHASE CANCER CTR.
Radiology (Diagnostic Radiology)
333 COTTMAN AVE, RADIOLOGY ASSOCIATES OF FCCC
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
ELENA DREYZIN PA-C
Physician Assistant
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (888) 369-2427
FREWEINI TESFALEDET PA
Physician Assistant
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
MARIUSZ A WASIK MD
Pathology (Anatomic Pathology)
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-3675
DR. BARBARA C. CAVANAUGH M.D.
Radiology (Diagnostic Radiology)
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-3883

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fox Chase Cancer Center Medical Group, Inc's NPI number?

The NPI number for Fox Chase Cancer Center Medical Group, Inc is 1083988166. It was assigned to this organization in the NPPES registry on March 7, 2012. The provider is doing business as Plastic/Recon Assoc Of Fccc, Mgi.

Where is Fox Chase Cancer Center Medical Group, Inc located?

Fox Chase Cancer Center Medical Group, Inc is located at 333 Cottman Ave Fox Chase Cancer Center, Philadelphia, PA 19111. The listed phone number is (215) 728-6900.

What is Fox Chase Cancer Center Medical Group, Inc's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

When was this NPI record last updated?

The NPPES record for Fox Chase Cancer Center Medical Group, Inc was last updated on June 14, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.