MEDICARE: JOHN P. SIMELARO 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
1	207R00000X	Internal Medicine Physician	OS002871L	PA
2	207RP1001X	Pulmonary Disease Physician	OS002871L	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	:	1477554541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN P. SIMELARO DO

Provider Business Mailing Address
First Line	:	4190 CITY AVE
Second Line	:	SUITE 315
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1626
Country	:	US
Telephone Number	:	215-871-6337
Fax Number	:	215-871-6347

Provider Business Practice Location Address
First Line	:	4190 CITY AVE
Second Line	:	SUITE 315
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1626
Country	:	US
Telephone Number	:	215-871-6337
Fax Number	:	215-871-6347

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	03/03/2016

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Directions to “ JOHN P. SIMELARO DO” Practice Location

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