Provider Demographics
NPI:1356781090
Name:MONACO, SPENCER JOSEPH (DPM)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:JOSEPH
Last Name:MONACO
Suffix:
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 1:915 OLD FERN HILL RD
Mailing Address - Street 2:BLDG. A STE. 1
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4269
Mailing Address - Country:US
Mailing Address - Phone:724-614-8750
Mailing Address - Fax:
Practice Address - Street 1:915 OLD FERN HILL RD
Practice Address - Street 2:BLDG. A STE. 1
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4269
Practice Address - Country:US
Practice Address - Phone:610-692-6280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006483213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery