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General NPI Number Information
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NPI Number | 1336478338
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Entity Type | Organization
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Legal Business Name | JEROME P. CASEY DPM PC
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 401 CHURCH ST
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City | ARCHBALD
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State | PA
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Zip | 18403-2101
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Country | US
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Telephone | 570-876-1440
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Fax | 570-876-0556
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Provider Business Mailing Address
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Address Line | 401 CHURCH ST
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City | ARCHBALD
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State | PA
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Zip | 18403-2101
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Country | US
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Telephone | 570-876-1440
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Fax | 570-876-0556
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. JEROME P CASEY
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Credential | DPM
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Telephone | 570-876-1440
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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 | SC002702L
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License Number State | PA
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