Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 0420010978 | VT |
Y | 208200000X | Surgeon | MD450096 | PA |
Y | 208600000X | Surgeon | MD450096 | PA |
NPI | 1013934843 |
---|---|
Provider Name | Dr. Antonio Di Carlo |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19140-5103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 21/03/2017 |