Provider Demographics
NPI:1083676514
Name:CUMBERLAND VALLEY FOOT AND ANKLE SPECIALISTS, PC
Entity Type:Organization
Organization Name:CUMBERLAND VALLEY FOOT AND ANKLE SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-761-3161
Mailing Address - Street 1:5108 E TRINDLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-761-3161
Mailing Address - Fax:717-763-9581
Practice Address - Street 1:5108 E TRINDLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-761-3161
Practice Address - Fax:717-763-9581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA544780Medicare PIN