=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063460624
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN A VOLPE D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2006
-----------------------------------------------------
Last Update Date | 05/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1203 LANGHORNE NEWTOWN RD STE 234
-----------------------------------------------------
City | LANGHORNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19047-1224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-750-2911
-----------------------------------------------------
Fax | 215-750-2917
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 103 OLD MARLTON PIKE STE 101
-----------------------------------------------------
City | MEDFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08055-8772
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-953-3440
-----------------------------------------------------
Fax | 609-953-8090
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | OS005356L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 25MB05264300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------