MEDICARE: PENNSYLVANIA RHEUMATOLOGY ASSOCIATES, P.C.

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

General Provider Information

NPI Number	:	1801841739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENNSYLVANIA RHEUMATOLOGY ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	822 PINE ST STE 3A
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-6187
Country	:	US
Telephone Number	:	215-829-5358
Fax Number	:	215-923-6442

Provider Business Practice Location Address
First Line	:	822 PINE ST STE 3A
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-6187
Country	:	US
Telephone Number	:	215-829-5358
Fax Number	:	215-923-6442

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	REGINA GAGGIANO
Credential	:
Telephone Number	:	215-829-5358

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	06/17/2022

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