Provider Demographics
NPI:1689717860
Name:SALVIA, JOHN AVERY (PA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:AVERY
Last Name:SALVIA
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-447-2000
Mailing Address - Fax:610-447-6606
Practice Address - Street 1:1703 S BROAD ST
Practice Address - Street 2:STE 300
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19148-1536
Practice Address - Country:US
Practice Address - Phone:215-462-7100
Practice Address - Fax:215-463-3820
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2016-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA001143L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA001143LOtherLICENSE NUMBER