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General NPI Number Information
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NPI Number | 1336200799
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Entity Type | Organization
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Legal Business Name | PAUL S. DEMARCO, DPM, LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 401 SHORE RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2630
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Country | US
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Telephone | 609-927-4894
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Fax | 609-601-1439
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Provider Business Mailing Address
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Address Line | 401 SHORE RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2630
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Country | US
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Telephone | 609-927-4894
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Fax | 609-601-1439
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL S DEMARCO
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Credential | DPM
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Telephone | 609-927-4894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | MD02049
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License Number State | NJ
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