Provider Demographics
NPI:1073548673
Name:VITTORIO, CARMELA C (MD)
Entity Type:Individual
Prefix:
First Name:CARMELA
Middle Name:C
Last Name:VITTORIO
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:3624 MARKET STREET STE 560W
Mailing Address - Street 2:UPHS OFFICE OF MEDICAL AFFAIRS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-2286
Mailing Address - Fax:215-349-8339
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:2 RHOADS PAVILION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-2737
Practice Address - Fax:215-349-8339
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068072L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017438890000ZMedicaid
F74285Medicare UPIN
PA0017438890000ZMedicaid