DR. MARIO ZICHELLA JR. (NPI# 1568656981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568656981 |
| Entity Type | Individual |
| Full Name | DR. MARIO ZICHELLA JR. |
| Credential | D.O. |
| Practice Address |
1025 Walnut Street Suite 700 Philadelphia PA 19107-3121 |
| Mailing Address |
9 N 9th St 718 Philadelphia PA 19107-3121 |
| Practice Telephone | 9738790509 |
| Mailing Telephone | 9738790509 |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2012-03-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
GBTQ6ZXW | PA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PA TRAINING LICENSE NUMBER | GBTQ6ZXW | 01 |
| Street Address |
1025 WALNUT STREET SUITE 700 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-3121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235333774 | Andrea Freeman Duncan | Pediatrics | 3401 Civic Center Blvd Fl 2, Philadelphia, PA 19104-4319 | 2007-06-11 |
| 1831302603 | Folasade Ibironke Kehinde | Pediatrics | 160 E Erie Ave Dept Of, Philadelphia, PA 19134-1011 | 2007-05-08 |
| 1639204225 | Kirstie R Marcello | Pediatrics | 111 South 11th Street, 7th Floor College Building, Philadelphia, PA 19107 | 2007-02-22 |
| 1134286677 | Yanick Mary Vibert | Pediatrics | 230 North Broad Street, Mailstop 492, 10th Floor South Tower Neonatology Office, Philadelphia, PA 19102 | 2007-01-03 |
| 1164476842 | Karen Fritz | Pediatrics | St. Christopher's Hospital Erie Ave and Front St, Div of Neonatology, Philadelphia, PA 19131 | 2006-05-19 |
| 1043274376 | Daniel Henry Conway | Pediatrics | Front St and Erie Ave, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2006-04-13 |
| 1720623200 | Stc Pediatrics LLC | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2019-11-08 |
| 1639713076 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
| 1750863619 | Temple Faculty Practice Plan, Inc | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| 1659803526 | Oluwatobi Adegboyega | Pediatrics | 833 Chestnut St Ste 1210, Philadelphia, PA 19107-4428 | 2017-03-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
Please comment or provide details below to improve the information on DR. MARIO ZICHELLA JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.