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General NPI Number Information
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NPI Number | 1407960396
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Entity Type | Organization
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Legal Business Name | MELROSE PODIATRY ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 1520 SNYDER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19145-3937
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Country | US
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Telephone | 215-462-2610
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Fax | 215-462-0445
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Provider Business Mailing Address
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Address Line | 1520 SNYDER AVENUE
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City | PHILADEPHIA
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State | PA
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Zip | 19145
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Country | US
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Telephone | 215-462-2610
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Fax | 215-462-0445
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL JOHN CHERELLA
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Credential | DPM
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Telephone | 215-462-2610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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