Doctor Name: | LORRAINE BOHANSKE POSSANZA |
NPI Number: | 1083937973 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.P.M. |
License Number: | SC 002693-L |
Business Practice Address: | 1246 W Main St Norristown, PA - 194014365 |
Business Phone Number: | 6102726554 |
Business Fax Number: | |
Mailing Address: | 418 Homestead Dr, WEST CHESTER |
State: | PA |
Postal Code: | 193828242 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/05/2010 |
NPI Last Update Date: | 03/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | SC 002693-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |