MEDICARE: BRUCE ZAPPAN, DPM, P.C.

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	213E00000X	Podiatrist	SC001854L	PA

General Provider Information

NPI Number	:	1760692172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE ZAPPAN, DPM, P.C.

Provider Business Mailing Address
First Line	:	1601 WALNUT ST STE 505
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2903
Country	:	US
Telephone Number	:	215-563-2560
Fax Number	:	215-563-1754

Provider Business Practice Location Address
First Line	:	1601 WALNUT ST STE 505
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2903
Country	:	US
Telephone Number	:	215-563-2560
Fax Number	:	215-563-1754

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	CINDY BUSSELL
Credential	:
Telephone Number	:	609-895-9700

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	12/08/2011

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