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Individual
PETER VASSALLUZZO
Active
Individual
PETER VASSALLUZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS006575L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0543451001
BLUE SHIELD
PA
01
—
1152
AETNA
PA
01
—
707562
HIGHMARK
PA
Enumeration date
07/03/2006
Last updated
06/18/2008
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