Healthcare Provider Details

I. General information

NPI: 1164663480
Provider Name (Legal Business Name): GIULIO ZUCCOLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER WOOD BUILDING, SUITE 2115
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

CHILDREN'S HOSPITAL OF PHILADELPHIA 3401 CIVIC CENTER BLVD, WOOD BUILDING SUITE 2115
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 267-426-2776
  • Fax:
Mailing address:
  • Phone: 267-426-2776
  • Fax: 412-692-6929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD436007
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: