LYCEUM LONGEVITY CENTER PLLC is a specialist in Philadelphia, PA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LYCEUM LONGEVITY CENTER PLLC NPI is 1831666585. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
6062 RIDGE AVE PHILADELPHIA, PA ZIP 19128-647 Phone: (215) 508-5555 Fax: (215) 508-5555
The provider's authorized official is William J Pezzello . The authorized official title is Co-founder and has the following contact phone number (215) 508-5555.
The enumeration date for this NPI number is 10/31/2018 and was last updated on 10/4/2019.
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 11/21/2025
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