Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP0504X | Public Medicine | SC006765 | SC |
N | 111NR0200X | Radiology | SC006765 | SC |
N | 213ER0200X | Radiology | SC006765 | SC |
N | 2081S0010X | Sports Medicine | SC006765 | SC |
N | 213ES0000X | Sports Medicine | SC006765 | SC |
Y | 213ES0103X | Foot & Ankle Surgery | SC006765 | PA |
N | 213ES0131X | Foot Surgery | SC006765 | SC |
NPI | 1952754012 |
---|---|
Provider Name | Colleen Parkinson Vetti |
First Address | Bensalem, PA 19020-2815 |
Second Address | Bensalem, PA 19020-2815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2016 |
Last Update Date | 18/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103616986-0001 | (05) | PA |
103616986-0002 | (05) | PA |
103616986-0003 | (05) | PA |
103616986-0004 | (05) | PA |