Healthcare Provider Details

I. General information

NPI: 1639584626
Provider Name (Legal Business Name): KELLEY M FIUMECALDO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 EASTON RD STE 12
WARRINGTON PA
18976-1818
US

IV. Provider business mailing address

1003 BIRDIE LN
DOYLESTOWN PA
18901-2800
US

V. Phone/Fax

Practice location:
  • Phone: 215-491-1963
  • Fax: 215-491-1850
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC006569
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: