Provider Demographics
NPI:1790768422
Name:DELGIORNO, THOMAS CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CHARLES
Last Name:DELGIORNO
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 1:10 E MORELAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3562
Mailing Address - Country:US
Mailing Address - Phone:267-385-5538
Mailing Address - Fax:267-437-3176
Practice Address - Street 1:10 E MORELAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3562
Practice Address - Country:US
Practice Address - Phone:267-437-3163
Practice Address - Fax:267-437-3176
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068804L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10090507204OtherAMERICHOICE
PA1009050720001Medicaid
PA2116593000OtherKEYSTONE HEALTH PLAN EAST
PA1431848OtherHIGHMARK BLUE SHIELD
PACA1374OtherRAILROAD MEDICARE
PA12945MD068804LOtherHEALTH PARTNERS
PA2116593000OtherPERSONAL CHOICE
PA2847239OtherAETNA
PA30018637OtherKEYSTONE MERCY
PA30018637OtherKEYSTONE MERCY
PAH62608Medicare UPIN