Provider Demographics
NPI:1063621191
Name:STEPHEN F FICCHI, DO, PC
Entity type:Organization
Organization Name:STEPHEN F FICCHI, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:J
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-752-1400
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5006
Mailing Address - Country:US
Mailing Address - Phone:215-750-9600
Mailing Address - Fax:215-750-8067
Practice Address - Street 1:3101 BRISTOL RD
Practice Address - Street 2:SUITE 9
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2168
Practice Address - Country:US
Practice Address - Phone:215-750-9600
Practice Address - Fax:215-750-8067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003881L320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities