Provider Demographics
NPI:1326042698
Name:SCHIAVONE, JOSEPH A (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:SCHIAVONE
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:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:2001 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3915
Practice Address - Country:US
Practice Address - Phone:610-442-2082
Practice Address - Fax:610-438-2419
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA052997207RC0000X, 207RI0011X
PAMD040241-L207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ52626200Medicaid
PA8533136OtherCIGNA PA
PA1450635Medicaid
PA2074401OtherCAPITAL BLUE CROSS
NJ1397190OtherHIGHMARK NJ
NJ85533136OtherCIGNA NJ
PA457723OtherAETNA US HEALTHCARE
PA726170OtherKEYSTONE CAPITAL
PA20010106Medicaid
PAP725722OtherOXFORD
PA726170OtherHIGHMARK PA
NJ85533136OtherCIGNA NJ
PA2074401OtherCAPITAL BLUE CROSS
PA726170OtherHIGHMARK PA