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NPI Code Detail

MEDICARE: DR. JEROME P CASEY D.P.M.

MEDICARE:  DR. JEROME P CASEY  D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristSC-002702 LPA

General Provider Information

NPI Number : 1053309716
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEROME P CASEY D.P.M.
Provider Business Mailing Address
First Line : 401 CHURCH ST
Second Line :
City : ARCHBALD
State : PA
Zip : 18403-2101
Country : US
Telephone Number : 570-876-1440
Fax Number : 570-876-0556
Provider Business Practice Location Address
First Line : 401 CHURCH ST
Second Line :
City : ARCHBALD
State : PA
Zip : 18403-2101
Country : US
Telephone Number : 570-876-1440
Fax Number : 570-876-0556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 06/23/2016

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