Healthcare Provider Details

I. General information

NPI: 1952754012
Provider Name (Legal Business Name): COLLEEN PARKINSON VETTI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3046 KNIGHTS RD
BENSALEM PA
19020-2815
US

IV. Provider business mailing address

3046 KNIGHTS RD
BENSALEM PA
19020-2815
US

V. Phone/Fax

Practice location:
  • Phone: 215-639-4500
  • Fax:
Mailing address:
  • Phone: 215-639-4500
  • Fax: 215-604-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberSC006765
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberSC006765
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberSC006765
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC006765
License Number StateSC
# 5
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006765
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: