Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD042002L | PA |
NPI | 1003865312 |
---|---|
Provider Name | John J Zurlo |
First Address | Philadelphia, PA 19107-4310 |
Second Address | Philadelphia, PA 19107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2006 |
Last Update Date | 29/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012065650001 | (05) | PA |
E55856 | (02) |