Organization
LABORATORY OF PODIATRIC PATHOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARVEY LEMONT DPM (PODIATRIST/LABORATORY DIRECTOR)
(215) 238-9831
Entity
Organization
Contact information
Practice address
801 ARCH ST, PHILADELPHIA, PA 19107-2413
(215) 238-9831
(215) 238-1873
Mailing address
801 ARCH ST, PHILADELPHIA, PA 19107-2413
(215) 238-9831
(215) 238-1873
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
021451
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021451
STATE PERMIT
PA
05
—
1192666101
—
PA
01
—
291U00000X
PROVIDER TAXONOMIES
PA
01
—
39D0657757
CLIA
PA
01
—
LA300113
MEDICARE
PA
01
—
LE137290
PODIATRY LICENSE
PA
Enumeration date
07/15/2009
Last updated
07/15/2009
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