Provider Demographics
NPI:1962401752
Name:RONDEAU, JOSEPH D (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:RONDEAU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1501 LANSDOWNE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1333
Mailing Address - Country:US
Mailing Address - Phone:610-237-7970
Mailing Address - Fax:610-237-7975
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:610-237-7970
Practice Address - Fax:610-237-7975
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC004741L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU94873Medicare UPIN
PA068974Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PA068974Medicare PIN