Provider Demographics
NPI:1922000868
Name:GIRARDO, SALVATORE P (MD)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:P
Last Name:GIRARDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:207 N BROAD ST
Mailing Address - Street 2:3RD FLR
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:215-462-7100
Mailing Address - Fax:215-463-3820
Practice Address - Street 1:1703 S BROAD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19148-1536
Practice Address - Country:US
Practice Address - Phone:215-463-5333
Practice Address - Fax:215-463-8085
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2013-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD011790E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006542560007Medicaid
PA0006542560007Medicaid