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1932148798

NPI Code Detail

MEDICARE: ALEXANDER RICHARD VACCARO M.D., PH.D.

MEDICARE: ALEXANDER RICHARD VACCARO M.D., PH.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	207XS0117X	Orthopaedic Surgery of the Spine Physician	C1-0006845	DE
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	25MA06332600	NJ
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	MD-13007	HI
4	207XS0117X	Orthopaedic Surgery of the Spine Physician	G73115	CA
5	207XS0117X	Orthopaedic Surgery of the Spine Physician	ME152589	FL
6	207XS0117X	Orthopaedic Surgery of the Spine Physician	MD042291E	PA
7	207XS0117X	Orthopaedic Surgery of the Spine Physician	290677-1	NY
8	207X00000X	Orthopaedic Surgery Physician	MD042291E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2378258	OTHER	NJ	AETNA
2	0466660	OTHER	PA	AETNA
3	0656057000	OTHER	PA	IBC
4	0363251000	OTHER	NJ	IBC
5	4181347	OTHER		CIGNA

General Provider Information

NPI Number	:	1932148798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER RICHARD VACCARO M.D., PH.D.

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST STE 520
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4430
Country	:	US
Telephone Number	:	800-321-9999
Fax Number	:	267-479-1321

Provider Business Practice Location Address
First Line	:	833 CHESTNUT ST STE 1220
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4413
Country	:	US
Telephone Number	:	800-321-9999
Fax Number	:	267-479-1321

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/27/2025

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Directions to “ ALEXANDER RICHARD VACCARO M.D., PH.D.” Practice Location

Language	Start Address	Practice Location

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