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General NPI Number Information
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NPI Number | 1477612653
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Entity Type | Organization
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Legal Business Name | BALDINO SOUTHWEST FAMILY PRACTICE
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5737 CHESTER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19143-5530
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Country | US
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Telephone | 215-726-5600
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Fax | 215-727-3236
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Provider Business Mailing Address
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Address Line | 5737 CHESTER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19143-5530
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Country | US
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Telephone | 215-726-5600
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Fax | 215-727-3236
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VINCENT E BALDINO
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Credential | D.O.
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Telephone | 215-726-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS003706L
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License Number State | PA
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