Provider Demographics
NPI:1093080608
Name:PA FOOT AND ANKLE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PA FOOT AND ANKLE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:TEICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-330-9740
Mailing Address - Street 1:175 S 21ST ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3835
Mailing Address - Country:US
Mailing Address - Phone:610-330-9740
Mailing Address - Fax:610-330-9742
Practice Address - Street 1:341 E BERTSCH ST
Practice Address - Street 2:
Practice Address - City:LANSFORD
Practice Address - State:PA
Practice Address - Zip Code:18232-2111
Practice Address - Country:US
Practice Address - Phone:570-805-4777
Practice Address - Fax:570-805-4779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA213E00000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty