Provider Demographics
NPI:1639584626
Name:FIUMECALDO, KELLEY M (DPM)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:M
Last Name:FIUMECALDO
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:215-491-1850
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006569213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty