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Individual

MARTIN FRANCIS REALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1335 W TABOR RD, SUITE 302, PHILADELPHIA, PA 19141-3038
(856) 697-9090
Mailing address
32 DRIFTWOOD COURT, GLASSBORO, NJ 08028-2846
(856) 697-9090

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00134100
NJ
213E00000X
Podiatrist
SC002395L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000849408
PA
05
1661001
NJ
01
185211
LICENSE
PA
01
SC002395L
LICENSE
PA
Enumeration date
09/15/2006
Last updated
08/18/2009
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