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Individual

DR. JUAN LUCAS POGGIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., M.S.

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3133
(215) 707-3945
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3133
(215) 707-3945

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD427752
PA
208C00000X
Colon & Rectal Surgery Physician
Primary
MD427752
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102645384
PA
Enumeration date
04/03/2007
Last updated
11/13/2019
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