MEDICARE: PIZZICA PEDIATRICS LLC

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1457348278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIZZICA PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	100 E LEHIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1012
Country	:	US
Telephone Number	:	215-707-1059
Fax Number	:	215-707-1049

Provider Business Practice Location Address
First Line	:	100 E LEHIGH AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1000
Country	:	US
Telephone Number	:	215-707-1059
Fax Number	:	215-707-1049

Authorized Official
Title or Position	:	PRESIDENT/CHIEF MEDICAL OFFICER
Name	:	ALBERT L PIZZICA
Credential	:	D.O.
Telephone Number	:	215-735-4519

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	09/15/2010

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Directions to “PIZZICA PEDIATRICS LLC ” Practice Location

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