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General NPI Number Information
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NPI Number | 1851736631
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Entity Type | Individual
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Provider Name | ELIZABETH KABERLE GAMBOGI MD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 33 SOUTH 9TH STREET SUITE 740
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4409
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Country | US
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Telephone | 215-955-6680
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Fax | 215-503-3333
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER BLVD DEPARTMENT OF MEDICINE 3 EAST
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City | CHESTER
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State | PA
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Zip | 19013-3902
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Country | US
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Telephone | 610-874-6114
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MT203498
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD461216
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License Number State | PA
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