1699401497 NPI number — IZZO FOOT AND ANKLE PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699401497 NPI number — IZZO FOOT AND ANKLE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IZZO FOOT AND ANKLE 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:
1699401497
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
984 STATE ROUTE 271
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIGONIER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15658-2570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-396-0933
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 S 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEANNETTE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15644-3422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-523-6700
Provider Business Practice Location Address Fax Number:
724-523-2242
Provider Enumeration Date:
07/26/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IZZO
Authorized Official First Name:
MARIBETH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
724-244-5968

Provider Taxonomy Codes

  • Taxonomy code: 213EP1101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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