Provider Demographics
NPI:1386647568
Name:NALLI, ALBERT R (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:R
Last Name:NALLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:510 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-2412
Mailing Address - Country:US
Mailing Address - Phone:724-266-3180
Mailing Address - Fax:724-266-1740
Practice Address - Street 1:510 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-2412
Practice Address - Country:US
Practice Address - Phone:724-266-3180
Practice Address - Fax:724-266-1740
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC001753L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008690830001Medicaid
PA120397OtherHIGHMARKBCBS
PAT-29241Medicare UPIN
PA120397SSHMedicare PIN