Peter J. Koblenzer

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD029332L Issued in PA

Legal business name

PETER J. KOBLENZER

Practice address

1812 Delancey St
Philadelphia, PA 19103-6607

Phone

(215) 545-4674

Fax

(215) 545-4809

NPI assigned

May 8, 2006

Last updated

Feb 20, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter J Koblenzer, MD

Title

Partner

Phone

(215) 545-4674

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1619926896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 DELANCEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036607",
            "telephone_number": "215-545-4674",
            "fax_number": "215-545-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 DELANCEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036607",
            "telephone_number": "215-545-4674",
            "fax_number": "215-545-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER J. KOBLENZER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "KOBLENZER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "215-545-4674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD029332L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peter Vassalluzzo D.O. (Lawndale Medical Associates)

• Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.