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General NPI Number Information
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NPI Number | 1932144417
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Entity Type | Organization
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Legal Business Name | SOUTHAMPTON PODIATRY ASSOCIATES
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 981 ROZEL AVE
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-4127
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Country | US
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Telephone | 215-357-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 981 ROZEL AVE
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-4127
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Country | US
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Telephone | 215-357-3668
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Fax |
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | DR. CLEMENT MICHAEL D'ANGELO
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Credential | D.P.M.
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Telephone | 215-357-3668
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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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