1417259938 NPI number — BARKINGDOGS FOOT AND ANKLE CARE, PC

Table of content: (NPI 1417259938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417259938 NPI number — BARKINGDOGS FOOT AND ANKLE CARE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARKINGDOGS FOOT AND ANKLE CARE, PC
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:
Provider Other Organization Name Type Code:
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:
1417259938
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 GERMANTOWN PIKE
Provider Second Line Business Mailing Address:
SUITE C3
Provider Business Mailing Address City Name:
PLYMOUTH MEETING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19462-2480
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-681-9485
Provider Business Mailing Address Fax Number:
484-681-9487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 GERMANTOWN PIKE
Provider Second Line Business Practice Location Address:
SUITE C3
Provider Business Practice Location Address City Name:
PLYMOUTH MEETING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19462-2480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-681-9485
Provider Business Practice Location Address Fax Number:
484-681-9487
Provider Enumeration Date:
12/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
PAGANO
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
484-681-9485

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  SC005966 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com