Provider Demographics
NPI:1083642136
Name:CHESTER COUNTY PODIARTRIC ASSOCIATES
Entity Type:Organization
Organization Name:CHESTER COUNTY PODIARTRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRAUDI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-696-4032
Mailing Address - Street 1:25 TURNER LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4805
Mailing Address - Country:US
Mailing Address - Phone:610-696-4032
Mailing Address - Fax:610-873-1467
Practice Address - Street 1:25 TURNER LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4805
Practice Address - Country:US
Practice Address - Phone:610-696-4032
Practice Address - Fax:610-873-1467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC2123L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0026794000OtherINDEPENDENCE BLUE CROSS
PAE61437OtherAMERIHEALTH
PA0000561437OtherHIGHMARK BLUE SHIELD
PA0000561437OtherHIGHMARK BLUE SHIELD