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General NPI Number Information
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NPI Number | 1922529056
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Entity Type | Individual
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Provider Name | LINDSAY MATTALYN HUMMEL DPM
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 3900 WOODLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4551
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Country | US
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Telephone | 215-823-5057
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Fax |
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Provider Business Mailing Address
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Address Line | 1283 SCHUYLKILL MOUNTAIN RD
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City | SCHUYLKILL HAVEN
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State | PA
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Zip | 17972-9143
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Country | US
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Telephone | 570-294-4290
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SC006841
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License Number State | PA
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