Provider Demographics
NPI:1518291905
Name:VASSALLO, RALPH ROBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:ROBERT
Last Name:VASSALLO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:700 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-3508
Mailing Address - Country:US
Mailing Address - Phone:215-451-4096
Mailing Address - Fax:215-451-2500
Practice Address - Street 1:700 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-3508
Practice Address - Country:US
Practice Address - Phone:215-451-4096
Practice Address - Fax:215-451-2500
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042201E207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology