John R Fontanilla M.D.

NPI 1669688412 - Internal Medicine - 207R00000X

NPI Details
NPI 1669688412
Gender Male
Enumeration Date 05/15/2007
Last Updated 07/27/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
4453 CASTOR AVE
SUITE B
PHILADELPHIA PA, 19124-3846, US
Phone (215) 744-2266
Fax (215) 743-9247
Business Location
4453 CASTOR AVE
SUITE B
PHILADELPHIA PA, 19124-3846, US
Phone (215) 744-2266
Fax (215) 743-9247
Toxanomy
Taxonomy Code 207R00000X
License State Pennsylvania
License Number MT188798
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According to our database, Dr. John R Fontanilla M.D. NPI is 1669688412, taxonomy code is 207R00000X and license number is MT188798, license state is located at Pennsylvania. John R Fontanilla M.D. physically located at 4453 Castor Ave, Philadelphia PA, 19124-3846. NPI Number John R Fontanilla M.D. has the Individual type.

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1669688412 NPI number is provided on an as is basis without warranty of any kind. 1669688412 is maintained by the National Plan & Provider Enumeration System. The contents of John R Fontanilla M.D. are for informational purposes only.