MEDICARE: JOSEPH J DEVENUTO . JR. M.D.

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
1	207W00000X	Ophthalmology Physician	MD009403E	PA
2	207W00000X	Ophthalmology Physician	25MA03164800	NJ

General Provider Information

NPI Number	:	1760417125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH J DEVENUTO . JR. M.D.

Provider Business Mailing Address
First Line	:	485 N MAIN ST
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-3403
Country	:	US
Telephone Number	:	215-345-6100
Fax Number	:	215-345-4151

Provider Business Practice Location Address
First Line	:	329 LINCOLN HWY
Second Line	:
City	:	FAIRLESS HILLS
State	:	PA
Zip	:	19030-1201
Country	:	US
Telephone Number	:	215-945-0200
Fax Number	:	215-945-2424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/27/2008

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