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Individual

MARIE LIDIA CARILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-4040
Mailing address
1012 LAUREL OAK RD, VOORHEES, NJ 08043-3505

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
25MA11550000
NJ
2080P0202X
Pediatric Cardiology Physician
Primary
MD478361
PA

Other

Enumeration date
05/15/2015
Last updated
09/19/2024
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