Intenzo, Charles M.

Intenzo, Charles M. is an individual health care provider with primary practice located at 111 S. 11Th Street Suite 3390, Philadelphia PA 19107-4824. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Nuclear Radiology. Allopathic & Osteopathic Physicians / Nuclear Radiology is his primary health care specialty. Intenzo, Charles M. can be contacted via phone (215) 955-2900.

Contact Information

Primary practice address
111 S. 11Th Street Suite 3390 Philadelphia PA 19107-4824
Fax: (215) 923-1562
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD025932E Pennsylvania
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X MD025932E Pennsylvania

Profile Details

NPI number 1669405346
LBN Legal business name Intenzo, Charles M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Dec 10th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669405346 NPPES
Pennsylvania MEDICAID 001073932
Pennsylvania MEDICAID 6377505
Pennsylvania MEDICAID 0010739320009

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