Provider Demographics
NPI:1306841051
Name:PROPATO, TERESA M (DPM)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:PROPATO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 EASTON RD STE 12
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1818
Mailing Address - Country:US
Mailing Address - Phone:215-491-1963
Mailing Address - Fax:215-491-1850
Practice Address - Street 1:1380 EASTON RD STE 12
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1818
Practice Address - Country:US
Practice Address - Phone:215-491-1963
Practice Address - Fax:215-491-1963
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-19
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004385L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU75155Medicare UPIN