Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS003845L | PA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | OS003845L | PA |
NPI | 1265417463 |
---|---|
Provider Name | Joseph P. Guagliardo |
First Address | Philadelphia, PA 19131-1626 |
Second Address | Philadelphia, PA 19131-1626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 12/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007003846 | (05) | PA |
B18094 | (02) |