Individual
DIANNA ELIZABETH VASSALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 S BRYN MAWR AVE # 203, BRYN MAWR, PA 19010-3121
(484) 337-3000
Mailing address
106 CALDWELL CT, COLMAR, PA 18915-3100
(267) 201-2102
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MA064802
PA
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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