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Organization

SOUTHAMPTON PODIATRY ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLEMENT MICHAEL D'ANGELO D.P.M. (PARTNER/OWNER)
(215) 357-3668
Entity
Organization

Contact information

Practice address
981 ROZEL AVE, SOUTHAMPTON, PA 18966-4127
(215) 357-3668
Mailing address
981 ROZEL AVE, SOUTHAMPTON, PA 18966-4127
(215) 357-3668

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009770320002
PA
01
0023131000
IDEPEN. BC/KEYSTONE,PC
PA
01
125780
BLUE SHIELD
PA
Enumeration date
06/18/2006
Last updated
12/17/2012
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