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General NPI Number Information
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NPI Number | 1730505272
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Entity Type | Organization
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Legal Business Name | N.E.P.A FOOT & ANKLE SPECIALISTS P.C.
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 75 WASHINGTON AVE
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City | PLYMOUTH
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State | PA
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Zip | 18651-1744
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Country | US
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Telephone | 570-287-1955
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Fax | 570-287-1995
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Provider Business Mailing Address
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Address Line | 75 WASHINGTON AVE
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City | PLYMOUTH
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State | PA
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Zip | 18651-1744
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Country | US
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Telephone | 570-287-1955
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Fax | 570-287-1995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHELLY ANN LEVULIS
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Credential | DPM
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Telephone | 570-287-1955
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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 | SC005978
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License Number State | PA
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