Healthcare Provider Details

I. General information

NPI: 1811175292
Provider Name (Legal Business Name): DR CHRISTOPHER PEZZI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 HIGHLAND AVE SUITE 604
ABINGTON PA
19001-3714
US

IV. Provider business mailing address

1245 HIGHLAND AVE SUITE 604
ABINGTON PA
19001-3714
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-7409
  • Fax: 215-481-2159
Mailing address:
  • Phone: 215-481-7409
  • Fax: 215-481-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD029403E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD029403E
License Number StatePA

VIII. Authorized Official

Name: DR. CHRISTOPHER PEZZI
Title or Position: DOCTOR
Credential: MD
Phone: 215-481-7410