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Organization
PETER VASSALLUZZO D.O.
Active
Organization
PETER VASSALLUZZO D.O.
Active
Other names
Lawndale Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER VASSALLUZZO DO (PHYSICIAN)
(215) 725-8111
Entity
Organization
Contact information
Practice address
6190 RISING SUN AVE, PHILADELPHIA, PA 19111-6011
(215) 725-8111
(215) 742-9501
Mailing address
6190 RISING SUN AVE, PHILADELPHIA, PA 19111-6011
(215) 725-8111
(215) 742-9501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS-006575L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0543451000
KEYSTONE
PA
Enumeration date
12/19/2006
Last updated
03/19/2013
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