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Individual

NICHOLAS S. CAVALLARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2301 S. BROAD STREET, 2ND FLOOR, PHILADELPHIA, PA 19148
(215) 952-9434
Mailing address
2301 S. BROAD STREET, 2ND FLOOR, PHILADELPHIA, PA 19148
(215) 952-9434

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD442053
PA
207R00000X
Internal Medicine Physician
MT193006
PA
208M00000X
Hospitalist Physician
Primary
MD442218
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102596637
PA
Enumeration date
07/20/2008
Last updated
12/10/2019
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