Maxwell Ambrosino, DO
Internal Medicine in Philadelphia, PA. Individual provider (NPI-1).
NPI number1265060164
StatusActive
Last updated in NPPESMar 1, 2024
Details
- NPI
- 1265060164
- Entity type
- Individual (NPI-1)
- Name
- Maxwell Ambrosino
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2020
- Certification date
- Mar 1, 2024
- Last updated
- Mar 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | OS022918 | PA | Yes |
Practice location
800 Spruce StPhiladelphia, PA 19107-6192
Phone 215-829-5410
Mailing address
800 Spruce St1 Pine West
Philadelphia, PA 19107-6130
Phone 215-829-5410
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