Dr. Alfio K Pennisi

 

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