Healthcare Provider Details

I. General information

NPI: 1891727343
Provider Name (Legal Business Name): ALI ALBERT ANAIM DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 E LEHIGH AVE
PHILADELPHIA PA
19125-1011
US

IV. Provider business mailing address

PO BOX 95000-1280
PHILADELPHIA PA
19195-1280
US

V. Phone/Fax

Practice location:
  • Phone: 215-423-9708
  • Fax: 215-423-4173
Mailing address:
  • Phone: 215-423-9708
  • Fax: 215-423-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004335L
License Number StatePA

VIII. Authorized Official

Name: DR. ALI ALBERT ANAIM
Title or Position: PRESIDENT
Credential: DPM
Phone: 215-423-9708