Provider Demographics
NPI:1073634622
Name:SCANZELLO, CARLA ROSE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:ROSE
Last Name:SCANZELLO
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:3900 WOODLAND AVE
Mailing Address - Street 2:PHILADELPHIA VA MEDICAL CENTER, BLD 21, RM A213
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4551
Mailing Address - Country:US
Mailing Address - Phone:215-823-5800
Mailing Address - Fax:215-823-6318
Practice Address - Street 1:3900 WOODLAND AVE
Practice Address - Street 2:PHILADELPHIA VA MEDICAL CENTER, BLD 21, RM A213
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4551
Practice Address - Country:US
Practice Address - Phone:215-823-5800
Practice Address - Fax:215-823-6318
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2015-07-17
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Provider Licenses
StateLicense IDTaxonomies
IL036.121480207RR0500X
PAMD449083207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology