Provider Demographics
NPI:1023019452
Name:SUSSEX FOOT AND ANKLE SPECIALISTS
Entity Type:Organization
Organization Name:SUSSEX FOOT AND ANKLE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FRANKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:570-409-0123
Mailing Address - Street 1:518 ROUTES 6 AND 209
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337
Mailing Address - Country:US
Mailing Address - Phone:570-409-0123
Mailing Address - Fax:845-495-0993
Practice Address - Street 1:518 ROUTES 6 & 209
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-9414
Practice Address - Country:US
Practice Address - Phone:570-409-0123
Practice Address - Fax:570-296-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC0044281213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100108354Medicare PIN
NJ067329Medicare PIN
PA4736220001Medicare NSC
PA067327Medicare PIN
U79404Medicare UPIN
NY4736220003Medicare NSC