Healthcare Provider Details
I. General information
NPI: 1114103942
Provider Name (Legal Business Name): JOHN S. TURRISI, DPM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2008
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 S 5TH ST
READING PA
19602-1692
US
IV. Provider business mailing address
103 S 5TH ST
READING PA
19602-1692
US
V. Phone/Fax
- Phone: 610-373-7118
- Fax: 610-685-1078
- Phone: 610-373-7118
- Fax: 610-685-1078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | SC003043-L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
S
TURRISI
Title or Position: OWNER
Credential: DPM
Phone: 610-373-7118