Provider Demographics
NPI:1336139815
Name:TURRISI, PAUL J (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:TURRISI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 STATE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1608
Mailing Address - Country:US
Mailing Address - Phone:610-373-7110
Mailing Address - Fax:610-373-7160
Practice Address - Street 1:2000 STATE HILL ROAD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1608
Practice Address - Country:US
Practice Address - Phone:610-373-7110
Practice Address - Fax:610-373-7160
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002913L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011464850002Medicaid
PA1881860872OtherMEDICARE DMEPOS ORGANIZATIONAL NPI
PA1336139815OtherINDIVIDUAL NPI
PA0011464850002Medicaid
PA1255160001Medicare NSC
PA148103Medicare PIN