Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC002364L | PA |
Y | 222Z00000X | Podiatrist | SC002364L | PA |
NPI | 1053350595 |
---|---|
Provider Name | Anthony Scalpato |
First Address | Havertown, PA 19083-2700 |
Second Address | Havertown, PA 19083-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 27/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T29206 | (02) | PA |