Provider Demographics
NPI:1003888405
Name:MOLINARO, JEFFREY TODD (DPM, FACFAS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:TODD
Last Name:MOLINARO
Suffix:
Gender:M
Credentials:DPM, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-1516
Mailing Address - Country:US
Mailing Address - Phone:412-787-8380
Mailing Address - Fax:412-787-1099
Practice Address - Street 1:101 DIXIE DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-1516
Practice Address - Country:US
Practice Address - Phone:412-787-8380
Practice Address - Fax:412-787-1099
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2787M213E00000X
PASC-003779R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0887895OtherMEDICARE ID
OH0887896OtherMEDICARE ID
OH1699772822OtherGROUP NPI
OH1184618639OtherGROUP NPI
PA1392756Medicaid
U39577Medicare UPIN
OH0887895OtherMEDICARE ID
OH1184618639OtherGROUP NPI