Provider Demographics
NPI:1083925192
Name:PODIATRY ASSOCIATES
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES
Other - Org Name:PODIATRY SX ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDOLPH
Authorized Official - Middle Name:VALENTINO
Authorized Official - Last Name:MCCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:412-654-5464
Mailing Address - Street 1:1236 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3037
Mailing Address - Country:US
Mailing Address - Phone:412-247-0610
Mailing Address - Fax:
Practice Address - Street 1:1236 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3037
Practice Address - Country:US
Practice Address - Phone:412-654-5464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002810L332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6400360001Medicare NSC