Individual
DR. LARRY J. ASSALITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1382 SCONSETT WAY, STATE COLLEGE, PA 16803-2438
(814) 826-5337
Mailing address
1382 SCONSETT WAY, STATE COLLEGE, PA 16803-2438
(814) 826-5337
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC-002410-L
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
SC-002410-L
PA
213ER0200X
Radiology Podiatrist
SC-002410-L
PA
213ES0000X
Sports Medicine Podiatrist
SC-002410-L
PA
213ES0000X
Sports Medicine Podiatrist
SC002410L
PA
213ES0131X
Foot Surgery Podiatrist
SC-002410-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000867765
—
PA
05
—
0008677650001
—
PA
Enumeration date
11/04/2006
Last updated
02/16/2021
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