MEDICARE: BURLINGTON COUNTY FOOT & ANKLE ASSOC, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	DA3758	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0000059327	OTHER	AMERIHEALTH ADMINISTRATOR
2	0022161000	OTHER	KEYSTONE EAST
3	0022161000	OTHER	AMERIHEALTH
4	0000059327	OTHER	BC/BS PERSONAL CHOICE

General Provider Information

NPI Number	:	1922009356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURLINGTON COUNTY FOOT & ANKLE ASSOC, INC

Provider Business Mailing Address
First Line	:	520 STOKES ROAD
Second Line	:	SUITE C-5
City	:	MEDFORD
State	:	NJ
Zip	:	08055
Country	:	US
Telephone Number	:	609-714-0052
Fax Number	:	609-714-3087

Provider Business Practice Location Address
First Line	:	520 STOKES ROAD
Second Line	:	SUITE C-5
City	:	MEDFORD
State	:	NJ
Zip	:	08055
Country	:	US
Telephone Number	:	609-714-0052
Fax Number	:	609-714-3087

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN M DEPALMA
Credential	:	DPM
Telephone Number	:	609-714-0052

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	11/24/2015

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Directions to “BURLINGTON COUNTY FOOT & ANKLE ASSOC, INC ” Practice Location

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