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NPI Code Detail

MEDICARE: MR. SALVATORE DESIMONE DO

MEDICARE: MR. SALVATORE DESIMONE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician0S007669LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
9180028017OTHERPARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1576732OTHERPAAETNA
2730706OTHERPAHIGHMARK BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4730706OTHERPABLUE SHEILD
510871OTHERPAHEALTHGUARD
60573185000OTHERPAKEYSTONE EAST
7990026OTHERPAKEYSTONE HEALTH PLAN L
81040332OTHERPAAMERIHEALTH
1027541OTHERPAHEALTH AMERICA
117990026OTHERPAGATEWAY

General Provider Information

NPI Number : 1083618029
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SALVATORE DESIMONE DO
Provider Business Mailing Address
First Line : 5001 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19124-2619
Country : US
Telephone Number : 215-288-5000
Fax Number : 215-744-1233
Provider Business Practice Location Address
First Line : 5001 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19124-2619
Country : US
Telephone Number : 215-288-5000
Fax Number : 215-744-1233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 02/07/2008

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Directions to “ MR. SALVATORE DESIMONE DO” Practice Location

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