Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD052559L | PA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD 052559L | PA |
NPI | 1013919570 |
---|---|
Provider Name | Vincenzo Berghella |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 10/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014900220010 | (05) | PA |
6866506 | (05) | NJ |
C15078 | (02) |