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NPI Code Detail

MEDICARE: AUBREY DIBELLO

MEDICARE: AUBREY DIBELLO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1679157366
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUBREY DIBELLO
Provider Business Mailing Address
First Line : 1217 SPRING GARDEN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-3212
Country : US
Telephone Number : 410-231-1163
Fax Number :
Provider Business Practice Location Address
First Line : 2900 W QUEEN LN
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1033
Country : US
Telephone Number : 215-991-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2021
Last Update Date : 05/08/2021

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Directions to “ AUBREY DIBELLO ” Practice Location

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