Organization
RADIOLOGY FOR SOUTH PHILADELPHIA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY CAPUTO (PRESIDENT)
(215) 952-9148
Entity
Organization
Contact information
Practice address
2301 S BROAD ST, 2ND FLOOR, PHILADELPHIA, PA 19148-3542
(215) 952-9148
(215) 952-9965
Mailing address
2301 S BROAD ST, 2ND FLOOR, PHILADELPHIA, PA 19148-3542
(215) 952-9148
(215) 952-9965
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0643243
—
PA
Enumeration date
06/16/2006
Last updated
02/28/2008
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