MEDICARE: EUSEBIO R. NUNEZ MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	MD039335E	PA

General Provider Information

NPI Number	:	1750426839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUSEBIO R. NUNEZ MD PC

Provider Business Mailing Address
First Line	:	1353 BRENTWOOD RD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-3924
Country	:	US
Telephone Number	:	215-533-2407
Fax Number	:	215-533-2408

Provider Business Practice Location Address
First Line	:	1216 E HUNTING PARK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-4928
Country	:	US
Telephone Number	:	215-533-2407
Fax Number	:	215-533-2408

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. EUSEBIO RAMOS NUNEZ
Credential	:	MD
Telephone Number	:	215-533-2407

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	08/22/2020

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