Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 036.121480 | IL |
Y | 207RR0500X | Rheumatology | MD449083 | PA |
NPI | 1073634622 |
---|---|
Provider Name | Dr. Carla Rose Scanzello |
First Address | Philadelphia, PA 19104-4551 |
Second Address | Philadelphia, PA 19104-4551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 17/07/2015 |