Provider Demographics
NPI:1902846421
Name:VIALIZ, JULIO E (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:E
Last Name:VIALIZ
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 1:1509 SCROPE ROAD
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-887-2049
Mailing Address - Fax:
Practice Address - Street 1:1201 LANGHORNE-NEWTOWN BLVD
Practice Address - Street 2:ST. MARY MEDICAL CENTER
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-710-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073275L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001843561Medicaid
PAH05230Medicare UPIN
PA048667Medicare ID - Type Unspecified