Organization
MERCURY PODIATRY, INC
Active
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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