MEDICARE: DR. STANLEY PELOSI M.D.

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	207Y00000X	Otolaryngology Physician	246131	NY
2	207Y00000X	Otolaryngology Physician	MD452360	PA

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	:	1346401478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY PELOSI M.D.

Provider Business Mailing Address
First Line	:	925 CHESTNUT ST FL 6
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4204
Country	:	US
Telephone Number	:	215-955-6760
Fax Number	:	215-923-4532

Provider Business Practice Location Address
First Line	:	925 CHESTNUT ST FL 6
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4204
Country	:	US
Telephone Number	:	215-955-6760
Fax Number	:	215-923-4532

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

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	12/26/2018

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