Provider Demographics
NPI:1689712606
Name:GIULIANO, ROBERT F (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:GIULIANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-2301
Mailing Address - Country:US
Mailing Address - Phone:215-629-1353
Mailing Address - Fax:215-629-1395
Practice Address - Street 1:1849 S 15TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2301
Practice Address - Country:US
Practice Address - Phone:215-629-1353
Practice Address - Fax:215-629-1395
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06984800207KI0005X
PAOS004431L207YX0905X
DEC20004052207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000515503Medicaid
DE099544Medicare ID - Type UnspecifiedMEDICARE NUMBER
DE0000515503Medicaid
PA0053374000Medicare ID - Type UnspecifiedPA MEDICAID
PA188495Medicare ID - Type UnspecifiedMEDICARE PA NUMBER