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Dr. Alfio K Pennisi

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NPI Number Detailed Information

Provider Information:

Name: Dr. Alfio K Pennisi
Gender: M
Provider License Number If Given: 25MA04964700

NPI Information:

NPI: 1902805286
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 5/31/2012

Provider Business Mailing Address:

Address: PO BOX 1710 SOUTH JERSEY RADIOLOGY ASSOCIATES, PA
Voorhees, NJ 08043
Phone Number: 8567700504
Fax Number: 8567700395

Provider Business Practice Location Address:

Address: 100 CARNIE BLVD SUITE B-5
Voorhees, NJ 08043
Phone Number: 8567510123
Fax Number: 8567510535

Provider Taxonomy:

Primary: 2085R0202X
Secondary (if any):
State: NJ