Healthcare Provider Details

I. General information

NPI: 1306713573
Provider Name (Legal Business Name): VERONICA M ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2536 N BROAD ST
PHILADELPHIA PA
19132-4013
US

IV. Provider business mailing address

2536 N BROAD ST
PHILADELPHIA PA
19132-4013
US

V. Phone/Fax

Practice location:
  • Phone: 835-239-3370
  • Fax:
Mailing address:
  • Phone: 835-239-3370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCO291303
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: