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Individual

DR. JOANN BEVILACQUA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
411 E MAIN ST, CARNEGIE, PA 15106-2048
(412) 279-3557
(412) 279-4357
Mailing address
411 E MAIN ST, CARNEGIE, PA 15106-2048
(412) 279-3557
(412) 279-4357

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC-000653L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00504099
PA
Enumeration date
12/14/2005
Last updated
11/19/2009
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