Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DS017472L | PA |
NPI | 1972555951 |
---|---|
Provider Name | Dr. Albert F Giallorenzi |
First Address | Scranton, PA 18510-2025 |
Second Address | Scranton, PA 18510-2025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T29808 | (02) | PA |