Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC001558L | PA |
N | 222Z00000X | Podiatrist | SC001558L | PA |
Y | 213ES0103X | Foot & Ankle Surgery | SC001558L | PA |
N | 213ES0131X | Foot Surgery | SC001558L | PA |
NPI | 1205892684 |
---|---|
Provider Name | Dr. Guido A Laporta |
First Address | Dunmore, PA 18512-2469 |
Second Address | Dunmore, PA 18512-2469 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 18/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000506182 | (05) | PA |
442480346 | RAILROAD MEDICARE (01) | PA |
T28758 | (02) | PA |