Provider Demographics
NPI:1831128826
Name:SIEGERMAN, JULIA BYE (DPM)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:BYE
Last Name:SIEGERMAN
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 1:648 CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-3805
Mailing Address - Country:US
Mailing Address - Phone:484-521-0233
Mailing Address - Fax:484-521-0235
Practice Address - Street 1:648 CHILDS AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3805
Practice Address - Country:US
Practice Address - Phone:484-521-0233
Practice Address - Fax:484-521-0235
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-003867-L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU57045Medicare UPIN
PA4299830001Medicare NSC
PA782525QD0Medicare PIN