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Organization
NORTH CENTRAL PENN PODIATRY PC
Active
Organization
NORTH CENTRAL PENN PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVAN J ANSELMI DPM (OWNER)
(570) 724-5297
Entity
Organization
Contact information
Practice address
103 WEST AVE, WELLSBORO, PA 16901-1358
(570) 724-5297
(570) 724-8793
Mailing address
103 WEST AVE, WELLSBORO, PA 16901-1358
(570) 724-5297
(570) 724-8793
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC0018534
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011971430002
—
PA
01
—
593990
HIGHMARK BS
—
01
—
CM5849
TRAVELERS MEDICARE
PA
Enumeration date
08/23/2005
Last updated
11/12/2007
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