Provider Demographics
NPI:1306945456
Name:NENNA, DAVID VITO (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VITO
Last Name:NENNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:26 STATION CIR
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-9726
Practice Address - Country:US
Practice Address - Phone:570-861-8710
Practice Address - Fax:570-497-4046
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03538500207XS0106X
PAMD041375E207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNE110493Medicare ID - Type UnspecifiedMEDICARE NUMBER
NJC57865Medicare UPIN