1699895037 NPI number — UPPER BUCKS FOOT & ANKLE MEDICAL CENTER PC

Table of content: (NPI 1699895037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699895037 NPI number — UPPER BUCKS FOOT & ANKLE MEDICAL CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPPER BUCKS FOOT & ANKLE MEDICAL CENTER 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:
1699895037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
249 S WEST END BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUAKERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18951-1160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-529-6511
Provider Business Mailing Address Fax Number:
215-529-6512

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
249 S WEST END BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUAKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18951-1160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-529-6511
Provider Business Practice Location Address Fax Number:
215-529-6512
Provider Enumeration Date:
03/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SEDICUM
Authorized Official First Name:
AUSTIN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PODIATRIST AND OWNER
Authorized Official Telephone Number:
215-529-6511

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC005511 , 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)

  • Identifier: 2103588000 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 613516600 . This is a "DEPARTMENT OF LABOR OWCP" identifier . This identifiers is of the category "OTHER".
  • Identifier: BS7453981 . This is a "INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 063480 . This is a "INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50016192 . This is a "CAPITAL INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7802379 . This is a "AETNA PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2941264 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 063479Q2K . This is a "INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417165 . This is a "BS INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1418639 . This is a "INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00276464 . This is a "INSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2105345000 . This is a "KEYSTONE GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50010317 . This is a "CAPITAL GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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