| Sean S Ciullo, MD | |
| 160 E Erie Ave, Philadelphia, PA 19134-1011 | |
| (215) 427-5446 | |
| (215) 427-4616 | 
| Full Name | Sean S Ciullo | 
|---|---|
| Gender | Male | 
| Speciality | Surgery - Pediatric Surgery | 
| Location | 160 E Erie Ave, Philadelphia, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1215199799 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | MD457437 (Pennsylvania) | Secondary | 
| 2086S0120X | Surgery - Pediatric Surgery | MD457437 (Pennsylvania) | Primary | 
| Entity Name | Stc Pediatrics Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1144864547 PECOS PAC ID: 7315372323 Enrollment ID: O20200122001254 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Sean S Ciullo, MD Po Box 13579, Reading, PA 19612-3579 Ph: (484) 628-1324 | Sean S Ciullo, MD 160 E Erie Ave, Philadelphia, PA 19134-1011 Ph: (215) 427-5446 | 
| Elizabeth Diane Dauer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3401 N Broad St, Philadelphia, PA 19140 Phone: 215-707-3133 Fax: 215-707-2915 | |
| Dr. Susete Carneiro, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3401 N Broad St, Philadelphia, PA 19140 Phone: 201-317-3485 | |
| Dr. Cassandra Alys Ligh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3401 Civic Center Blvd, Philadelphia, PA 19104 Phone: 215-590-2208 Fax: 267-425-9552 | |
| Victor Kim, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3900 Woodland Ave, Philadelphia, PA 19104 Phone: 215-823-5800 | |
| James Sun, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 333 Cottman Ave, Philadelphia, PA 19111 Phone: 215-854-9799 | |
| Simran Kripalani, MD Surgery Medicare: Medicare Enrolled Practice Location: 3401 N Broad St, Philadelphia, PA 19140 Phone: 215-717-2000 | |
| Adrian W Ong, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3400 Spruce Street, 2 Dulles, Philadelphia, PA 19104 Phone: 215-662-7320 Fax: 412-359-8639 |