Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | OS007242L | PA |
NPI | 1104877869 |
---|---|
Provider Name | Dr. Christopher J Vassalluzzo |
First Address | New Hope, PA 18938-9283 |
Second Address | Easton, PA 18042-3851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F12943 | (02) |