Provider Demographics
NPI:1548344229
Name:ONCOLOGY & HEMATOLOGY, PA
Entity type:Organization
Organization Name:ONCOLOGY & HEMATOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-629-0260
Mailing Address - Street 1:701 MIDDLEFORD RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3600
Mailing Address - Country:US
Mailing Address - Phone:302-629-0260
Mailing Address - Fax:302-629-3418
Practice Address - Street 1:701 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3600
Practice Address - Country:US
Practice Address - Phone:302-629-0260
Practice Address - Fax:302-629-3418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10001859207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DECH4887OtherRAILROAD MEDICARE
DEG254OtherBCBS DC
DE0000596902OtherDPCI
DE0859121000OtherAMERIHEALTH
DELS05OtherCAREFIRST
DE0000596902Medicaid
DE=========3OtherBCBS DE
DE=========OtherAETNA
DECH4887OtherRAILROAD MEDICARE
DELS05OtherCAREFIRST
DE=========OtherALLIANCE,MAMSI,OPT CHOICE
DE=========OtherCOVENTRY
DE=========OtherUNITED HEALTHCARE
DE=========OtherCOVENTRY
DEG00270Medicare ID - Type UnspecifiedMEDICARE