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Individual

BRUCE CARNIVALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3401 N BROAD ST, 7TH FLOOR OUT PATIENT BUILDING, PHILADELPHIA, PA 19140-5103
(215) 707-3008
(215) 707-1387
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3008
(215) 707-1387

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
OS 007278L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001461989
PA
01
0146198902
AMERICHOICE
PA
01
045941
HIGHMARK BLUE SHIELD
PA
01
0678844
CIGNA
PA
01
0717488000
INDEPENDENCE BLUE CROSS
PA
01
1016307
KEYSTONE MERCY HEALTH PLA
PA
01
3122336
AETNA HMO
PA
01
4476096
AETNA PPO
PA
01
597586
MEDICARE GROUP TPI
PA
01
CD4829
RR MEDICARE TPI GROUPS
PA
01
P00025012
RAIL ROAD MEDICARE
PA
Enumeration date
12/15/2005
Last updated
03/21/2017
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