Provider Demographics
NPI:1528053535
Name:VLAHOVIC, TRACEY CHRISTINE (DPM)
Entity type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:CHRISTINE
Last Name:VLAHOVIC
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22433
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2433
Mailing Address - Country:US
Mailing Address - Phone:215-777-5801
Mailing Address - Fax:215-777-5716
Practice Address - Street 1:148 N 8TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-2418
Practice Address - Country:US
Practice Address - Phone:215-777-5808
Practice Address - Fax:215-777-5825
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004751L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029769OtherNJ MEDICAL ASSISTANCE
PA231365971OtherHUMANA
PA231365971071OtherTRI-CARE
PA1530858OtherKEYSTONE HEALTH PLAN PPO
PA1969474Medicaid
PA3Y4987OtherHEALTH NET
PA436224OtherHEALTH AMERICA HEALTH ASSURANCE
PAP3213656OtherOXFORD
PA0019694740002Medicaid
PA1092074OtherAETNA HMO
PA2216250000OtherKEYSTONE HEALTH PLAN HMO
PAP12042552OtherMULTI-PLAN
PAVL1530858OtherBLUE SHIELD OF PA
PA28824OtherHEALTH PARTNERS
PAP00399669OtherRAILROAD MEDICARE
PA2332158OtherCIGNA
PA7947715OtherAETNA PPO
PA13090OtherELDER HEALTH / BRAVO
PA231365971OtherUNITED HEALTH CARE
PA30010156OtherKEYSTONE MERCY
PA7947715OtherAETNA PPO
U96255Medicare UPIN