Baldassari, Elmo William

Baldassari, Elmo William is an sole proprietor health care provider with primary practice located at 1439 Monroe Ave Ste 3 , Dunmore PA 18509-2497. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Baldassari, Elmo William can be contacted via phone (570) 963-1974.

Contact Information

Primary practice address
1439 Monroe Ave Ste 3 Dunmore PA 18509-2497
Phone: (570) 963-1974
Fax: (570) 963-0762
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC003666L Pennsylvania

Profile Details

NPI number 1497799415
LBN Legal business name Baldassari, Elmo William
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2006
Last updated Apr 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497799415 NPPES
Pennsylvania Other 480024264 RAILROAD MEDICARE
Pennsylvania MEDICAID 0016528000002 RAILROAD MEDICARE

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