Individual
TRINITY J BIVALACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
3400 CIVIC CENTER BLVD, WEST PAVILION 3RD FLOOR, PHILADELPHIA, PA 19104-5127
(215) 662-2891
(215) 662-6734
Mailing address
3400 CIVIC CENTER BLVD, WEST PAVILION 3RD FLOOR, PHILADELPHIA, PA 19104-5127
(215) 662-2891
(215) 662-6734
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD475725
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028033000
—
MD
Enumeration date
01/31/2007
Last updated
12/22/2021
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