Healthcare Provider Details

I. General information

NPI: 1801396106
Provider Name (Legal Business Name): DEBRA CIPRIANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 02/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1648 HUNTINGDON PIKE CHCA NEONATOLOGY
JENKINTOWN PA
19046-8001
US

IV. Provider business mailing address

100 PENN SQUARE EAST, 9TH FL NORTH TOWER CHCA NEONATOLOGY
PHILADELPHIA PA
19107
US

V. Phone/Fax

Practice location:
  • Phone: 215-938-2903
  • Fax: 215-938-2905
Mailing address:
  • Phone: 267-425-9200
  • Fax: 267-425-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD037133E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: