Provider Demographics
NPI:1013186865
Name:VINCENZO R. SANGUINETI MD PC
Entity Type:Organization
Organization Name:VINCENZO R. SANGUINETI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENZO
Authorized Official - Middle Name:RICCARDO
Authorized Official - Last Name:SANGUINETI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-592-8641
Mailing Address - Street 1:1015 CHESTNUT ST
Mailing Address - Street 2:SUITE 825
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4316
Mailing Address - Country:US
Mailing Address - Phone:215-592-8641
Mailing Address - Fax:215-592-9273
Practice Address - Street 1:1015 CHESTNUT ST
Practice Address - Street 2:SUITE 825
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4316
Practice Address - Country:US
Practice Address - Phone:215-592-8641
Practice Address - Fax:215-592-9273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042793E261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
D77056Medicare UPIN
121525Medicare PIN