1003844697 NPI number — FOOT AND ANKLE ASSOCIATES LLP

Table of content: (NPI 1003844697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003844697 NPI number — FOOT AND ANKLE ASSOCIATES LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT AND ANKLE ASSOCIATES LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVANCED FOOT AND ANKLE CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003844697
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
692 UNIONVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNETT SQUARE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19348-1704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-444-6520
Provider Business Mailing Address Fax Number:
104-444-2232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
692 UNIONVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNETT SQUARE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-444-6520
Provider Business Practice Location Address Fax Number:
610-444-2232
Provider Enumeration Date:
06/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
IANNUCCI
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
SENIOR MANAGING PARTNER
Authorized Official Telephone Number:
610-444-6520

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000544728 . This is a "MEDICARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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