Healthcare Provider Details

I. General information

NPI: 1558307785
Provider Name (Legal Business Name): DAVID J CHROMEY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 S MAIN ST
OLD FORGE PA
18518-1497
US

IV. Provider business mailing address

821 S MAIN ST SUITE 2
OLD FORGE PA
18518-1497
US

V. Phone/Fax

Practice location:
  • Phone: 570-457-5544
  • Fax: 570-457-5511
Mailing address:
  • Phone: 570-457-5544
  • Fax: 570-457-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004070L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier21460 1166
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGEISINGER
# 2
Identifier800088
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerFIRST PRIORITY HMO
# 3
Identifier21460 1166
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGEISINGER GOLD
# 4
Identifier73791
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUNISON MEDPLUS
# 5
IdentifierPO32929
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerTRICARE FOR LIFE
# 6
Identifier2286071
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA
# 7
Identifier0015055820002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 8
Identifier601818
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerFIRST PRIORITY LIFE INSURANCE COMPANY
# 9
Identifier601818
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE SHIELD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: