MEDICARE: DR. LAWRENCE CAPOZELLO 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
1	213E00000X	Podiatrist	SC000153L	PA

General Provider Information

NPI Number	:	1932207875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE CAPOZELLO DPM

Provider Business Mailing Address
First Line	:	148 SOUTH 5TH ST
Second Line	:
City	:	READING
State	:	PA
Zip	:	19602
Country	:	US
Telephone Number	:	610-376-2074
Fax Number	:	610-685-7849

Provider Business Practice Location Address
First Line	:	4148 KUTZTOWN RD
Second Line	:
City	:	TEMPLE
State	:	PA
Zip	:	19560
Country	:	US
Telephone Number	:	610-375-0395
Fax Number	:	610-685-7849

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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