David S Vanderlyke D P M

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SCOO3874L Issued in PA

Legal business name

DAVID S VANDERLYKE D P M

Practice address

842 Red Lion Rd Ste 10
Philadelphia, PA 19115-1475

Phone

(215) 673-7036

Fax

(215) 673-9670

NPI assigned

Jan 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David S Vanderlyke, D P M

Title

DPM

Phone

(215) 673-7036

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1043496326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 RED LION RD STE 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151475",
            "telephone_number": "215-673-7036",
            "fax_number": "215-673-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 RED LION RD STE 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151475",
            "telephone_number": "215-673-7036",
            "fax_number": "215-673-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S VANDERLYKE D P M",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "VANDERLYKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "215-673-7036",
        "authorized_official_credential": "D P M"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SCOO3874L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.