Provider Demographics
NPI:1942385810
Name:WEITZEN, JULI ANN (DPM)
Entity Type:Individual
Prefix:
First Name:JULI
Middle Name:ANN
Last Name:WEITZEN
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 1:828 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:610-323-1406
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003193L213E00000X
PASC0031963L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000143405OtherHIGHMARK BLUE SHIELD
PAA43405OtherINTERCOUNTY
PA0741560001OtherMEDICARE DMEPOS
NJ2325902940OtherHORIZON BC/BS
PA27-01105OtherEVERCARE
PA232590294OtherPEBTF
PA1112351Medicaid
PA50001567OtherCAPITAL BLUE CROSS
PA00083575000OtherINDEPENDENCE BLUE CROSS
PA232590294OtherPEBTF
PA000143405OtherHIGHMARK BLUE SHIELD
PA27-01105OtherEVERCARE