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General NPI Number Information
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NPI Number | 1225441223
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Entity Type | Individual
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Provider Name | MICHAEL GIZZIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | 230 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1121
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Country | US
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Telephone | 215-762-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 AUTUMN RIVER RUN
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City | PHILADELPHIA
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State | PA
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Zip | 19128-4362
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MT206731
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License Number State | PA
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