Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD062077L | PA |
NPI | 1275584609 |
---|---|
Provider Name | Richard J Bleicher |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19111-2434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 12/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1016362550001 | (05) | PA |
H31105 | (02) | PA |