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General NPI Number Information
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NPI Number | 1013919570
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Entity Type | Individual
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Provider Name | VINCENZO BERGHELLA MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 833 CHESTNUT ST 1ST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4414
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Country | US
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Telephone | 215-955-5000
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Fax | 215-923-1089
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST 1ST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD 052559L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD052559L
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License Number State | PA
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