MEDICARE: OSCAR HORACIO IRIGOYEN MD

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
1	207RR0500X	Rheumatology Physician	146326	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114929585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR HORACIO IRIGOYEN MD

Provider Business Mailing Address
First Line	:	1015 WALNUT ST
Second Line	:	STE 613
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5005
Country	:	US
Telephone Number	:	215-955-1415
Fax Number	:	215-955-7885

Provider Business Practice Location Address
First Line	:	1015 WALNUT ST
Second Line	:	STE 613
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5005
Country	:	US
Telephone Number	:	215-955-1415
Fax Number	:	215-955-7885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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