Healthcare Provider Details

I. General information

NPI: 1013191824
Provider Name (Legal Business Name): JOSEPHINE DEPALMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 N 5TH ST
PHILADELPHIA PA
19133-2701
US

IV. Provider business mailing address

2706 N 5TH ST
PHILADELPHIA PA
19133-2701
US

V. Phone/Fax

Practice location:
  • Phone: 215-425-5060
  • Fax: 215-483-9679
Mailing address:
  • Phone: 215-425-5060
  • Fax: 215-483-9679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC002712L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberSC002712L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC002712L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC002712L
License Number StatePA

VIII. Authorized Official

Name: DR. JOSEPHINE DEPALMA
Title or Position: DR
Credential: DPM
Phone: 215-425-5060