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NPI Code Detail

MEDICARE: DR. JOANN BEVILACQUA DPM

MEDICARE:  DR. JOANN  BEVILACQUA  DPM
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
1213EP1101XPrimary Podiatric Medicine PodiatristSC-000653LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558346403
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOANN BEVILACQUA DPM
Provider Business Mailing Address
First Line : 411 E MAIN ST
Second Line :
City : CARNEGIE
State : PA
Zip : 15106-2048
Country : US
Telephone Number : 412-279-3557
Fax Number : 412-279-4357
Provider Business Practice Location Address
First Line : 411 E MAIN ST
Second Line :
City : CARNEGIE
State : PA
Zip : 15106-2048
Country : US
Telephone Number : 412-279-3557
Fax Number : 412-279-4357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 11/19/2009

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Directions to “ DR. JOANN BEVILACQUA DPM” Practice Location

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