Provider Demographics
NPI:1013191824
Name:JOSEPHINE DEPALMA
Entity Type:Organization
Organization Name:JOSEPHINE DEPALMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPALMA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-425-5060
Mailing Address - Street 1:2706 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-2701
Mailing Address - Country:US
Mailing Address - Phone:215-425-5060
Mailing Address - Fax:215-483-9679
Practice Address - Street 1:2706 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2701
Practice Address - Country:US
Practice Address - Phone:215-425-5060
Practice Address - Fax:215-483-9679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPHINE DEPALMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002712L213E00000X, 213EP1101X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001010790006Medicaid
PADE454937Medicare PIN
PA001010790006Medicaid
PA0527760001Medicare NSC