Individual
ANGELO ILLUZZI
Active
Individual
ANGELO ILLUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0S008438L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014671870004
—
PA
01
—
104291
UPMC
PA
01
—
13489
GEISINGER
PA
01
—
610283400
BLACK LUNG
—
01
—
740698
BLUE SHIELD
PA
01
—
P00233037
METRAHEALTH RAILROAD MEDI
—
Enumeration date
08/30/2006
Last updated
06/21/2016
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