Individual
KIMBERLY GAIL DICUCCIO HECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25 S 9TH ST, 1ST FLOOR, PHILADELPHIA, PA 19107-4408
(215) 955-1200
(215) 923-6808
Mailing address
25 S 9TH ST, 1ST FLOOR, PHILADELPHIA, PA 19107-4408
(215) 955-1200
(215) 923-6808
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
25MA08167900
NJ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD428823
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0186953
—
NJ
05
—
103099037
—
PA
Enumeration date
05/01/2007
Last updated
12/19/2018
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