Individual
GARY J VIGILANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 N 39TH ST, PHI BLDG STE 2C PENN PRESBYTERIAN MEDICAL CENTER, PHILADELPHIA, PA 19104-2640
(215) 662-9010
Mailing address
51 N 39TH ST, PHI BLDG STE 2C PENN PRESBYTERIAN MEDICAL CTR, PHILADELPHIA, PA 19104-2640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD030941E
PA
207RC0000X
Cardiovascular Disease Physician
25MA10752200
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
MD030941E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010479600012
—
PA
Enumeration date
07/04/2006
Last updated
02/15/2022
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