Provider Demographics
NPI:1205828787
Name:DEPALMA, JOHN M (DPM)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:DEPALMA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:520 STOKES ROAD
Mailing Address - Street 2:SUITE C-5
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055
Mailing Address - Country:US
Mailing Address - Phone:609-714-0052
Mailing Address - Fax:609-714-3087
Practice Address - Street 1:520 STOKES ROAD
Practice Address - Street 2:SUITE C-5
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055
Practice Address - Country:US
Practice Address - Phone:609-714-0052
Practice Address - Fax:609-714-3087
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002233213E00000X
NJ25MD00223300213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
220463OtherVSFHP
0763611000OtherAMERIHEALTH HMO
223434672OtherAMER. PREFERRED PROVIDER
223434672OtherDIRECT CARE AMERICA
00000089143OtherBETTER HEALTH ADVANTAGE
480034600OtherRR MEDICARE
317027OtherDIVON
0000616345OtherBC/BS PERSONAL CHOICE
0762611000OtherKEYSTONE - EAST
0763611000OtherAMERIHEALTH POS
0763611000OtherAMERIHEALTH PERSONAL CH
0763611000OtherAMERIHEALTH PPO
F17329OtherHEALTH NET
0000616345OtherAMERIHEALTH ADMINISTRATOR
4623650001OtherHEALTH NOW
8982930OtherCIGNA
4623650001OtherHEALTH NOW
480034600OtherRR MEDICARE
DE616345Medicare ID - Type Unspecified