IndividualActive
Mark Ettore, MD
NPI 1902250244 · Pediatric Anesthesiology Physician · Philadelphia, PA
Provider details
- NPI number
- 1902250244
- Entity type
- Individual
- Primary specialty
- Pediatric Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MT210596 (PA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-4557
Approximate (ZIP-level) locationGet directions
Mailing address
3870 Manor St
Philadelphia, PA 19128-5206
Registry dates
- Enumerated
- 2016-04-22
- Last updated
- 2024-05-07
- Certified
- 2020-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.