Provider Demographics
NPI:1295751105
Name:ORLANDO, JOHN J JR (DPM)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:ORLANDO
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8014 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3056
Mailing Address - Country:US
Mailing Address - Phone:215-487-2222
Mailing Address - Fax:215-487-2222
Practice Address - Street 1:8014 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-3056
Practice Address - Country:US
Practice Address - Phone:215-487-2222
Practice Address - Fax:215-487-2222
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-001435-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT72403Medicare UPIN
PA44645Medicare ID - Type UnspecifiedMEDICARE