Healthcare Provider Details

I. General information

NPI: 1215986377
Provider Name (Legal Business Name): DANIEL JOSEPH VILE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8012 FRANKFORD AVE
PHILADELPHIA PA
19136-2616
US

IV. Provider business mailing address

PO BOX 16335
PHILADELPHIA PA
19114-0435
US

V. Phone/Fax

Practice location:
  • Phone: 215-624-1758
  • Fax: 215-624-3153
Mailing address:
  • Phone: 215-969-7510
  • Fax: 215-969-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOS006269L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberOS006269L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: