MEDICARE: DR. LUIGI ANTHONY CIANCI MD

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	207R00000X	Internal Medicine Physician	MD016134-E	PA

General Provider Information

NPI Number	:	1770564619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIGI ANTHONY CIANCI MD

Provider Business Mailing Address
First Line	:	2801 ISLAND AVE
Second Line	:	SUITE 5
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2326
Country	:	US
Telephone Number	:	215-365-5545
Fax Number	:	215-365-1522

Provider Business Practice Location Address
First Line	:	2801 ISLAND AVE
Second Line	:	SUITE 5
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2326
Country	:	US
Telephone Number	:	215-365-5545
Fax Number	:	215-365-1522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/31/2008

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