Provider Demographics
NPI:1053300921
Name:D'ORAZIO, EDWARD ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALFRED
Last Name:D'ORAZIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N BROAD ST.
Mailing Address - Street 2:TEMPLE UNIV. HOSPITAL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:215-707-4250
Mailing Address - Fax:215-707-9389
Practice Address - Street 1:3401 N BROAD ST.
Practice Address - Street 2:TEMPLE UNIV. HOSPITAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-4250
Practice Address - Fax:215-707-9389
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD006895E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00925900016Medicaid
141259Medicare ID - Type Unspecified
C31559Medicare UPIN
PAC31559Medicare UPIN