Provider Demographics
NPI:1477626372
Name:JULI WEITZEN DPM
Entity Type:Organization
Organization Name:JULI WEITZEN DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULI
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEITZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-327-8554
Mailing Address - Street 1:828 N HANOVER STREET
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:610-327-8554
Mailing Address - Fax:610-323-1406
Practice Address - Street 1:828 N HANOVER STREET
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464
Practice Address - Country:US
Practice Address - Phone:610-327-8554
Practice Address - Fax:484-449-9684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-003193L213E00000X
PASC0031963L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0083575000OtherPERSONAL CHOICE
PA27-01105OtherEVERCARE
PAA43405OtherINTERCOUNTY
PA000143405OtherHIGHMARK BLUE SHIELD
PA1112351Medicaid
PA50001567OtherCAPITAL BLUE CROSS
PAT29547OtherUPIN
PA0083575000OtherPERSONAL CHOICE
PA0741560001Medicare NSC
PA143405Medicare UPIN
PA=========OtherPEBTF