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Organization

MERCURY PODIATRY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL FRANK HALUSKA D.P.M. (PRESIDENT)
(610) 874-8431
Entity
Organization

Contact information

Practice address
4201 EDGMONT AVE, BROOKHAVEN, PA 19015-2315
(610) 874-8431
(610) 874-8288
Mailing address
4201 EDGMONT AVE, BROOKHAVEN, PA 19015-2315
(610) 874-8431
(610) 874-8288

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
SC001693L
PA
335E00000X
Prosthetic/Orthotic Supplier
Primary
SC001693L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00005014350002
PA
01
088440
BLUE SHIELD
PA
01
21283
HEALTHPARTNERS
PA
01
J88440
AMERIHEALTH OF PA
PA
Enumeration date
08/14/2006
Last updated
07/07/2008
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