Provider Demographics
NPI:1336177815
Name:ALTOMARI, GIA NINA (MD)
Entity Type:Individual
Prefix:DR
First Name:GIA
Middle Name:NINA
Last Name:ALTOMARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GIA
Other - Middle Name:NINA
Other - Last Name:ERBICELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1901
Mailing Address - Country:US
Mailing Address - Phone:610-627-0848
Mailing Address - Fax:
Practice Address - Street 1:1 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1901
Practice Address - Country:US
Practice Address - Phone:610-627-0848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062106L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356 SK3Medicare PIN